1
|
Phan H, Daines CL, Woo T, Psoter KJ, Goodman A, McWilliams E, Frederick C, Milla C, Oates G, Sawicki GS, Riekert KA. Development and preliminary validation of the personalized cystic fibrosis medication questionnaire (PCF-MQ). J Cyst Fibros 2024:S1569-1993(24)00073-0. [PMID: 38851920 DOI: 10.1016/j.jcf.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 05/10/2024] [Accepted: 05/20/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND A personalized approach to assessing medication knowledge may identify opportunities for education to support self-management of cystic fibrosis (CF). This project describes the development, scoring, and preliminary validity of the Personalized CF Medication Questionnaire (PCF-MQ), designed to assess knowledge of prescribed CF medication purpose, administration, and dose and frequency. METHODS Participants completed the PCF-MQ, the Knowledge of Disease Management (KDM-CF), and the Cystic Fibrosis-Medication Beliefs Questionnaire (CF-MBQ). Prescribed regimens were abstracted from medical records. Eligibility criteria were age 12 years and older, diagnosed with CF, and prescribed a CF medication. Statistical analyses were conducted using R software. Spearman rho was used to test correlations between measures. RESULTS Sixty people with CF (pwCF) were enrolled; three people reported a regimen that substantially deviated from the medical record and were excluded from the analyses. The mean (SD) age was 20.2 (7.3) years, 54 % were female, and 74 % had a FEV1pp ≥70 %. The mean (SD) PCF-MQ total score was 77.8 (12.3) and knowledge scores ranged from a low of 58.3 for levalbuterol to 100 for ivacaftor. The PCF-MQ total score correlated with the KDM total score and subscales (Spearman Rho= 0.32-0.59, p < 0.05) and was not correlated with the CF-MBQ subscales (p > 0.05)). CONCLUSIONS The PCF-MQ was correlated with another measure of general CF knowledge, but not health beliefs; because of the small sample size, this should be considered preliminary evidence of its validity. Advantages over existing CF knowledge measures include its practicality for use to help assess pwCF's knowledge about their prescribed regimen.
Collapse
Affiliation(s)
- Hanna Phan
- Department of Clinical Pharmacy, University of Michigan, College of Pharmacy, Michigan Medicine, C.S. Mott Children's Hospital, 428 Church Street, Ann Arbor, MI 48109, USA.
| | - Cori L Daines
- Department of Pediatrics, University of Arizona College of Medicine, Banner University Medical Center-Tucson, PO Box 245073, Tucson, AZ 85724, USA
| | - Ti Woo
- Department of Medicine, Johns Hopkins University, School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA
| | - Kevin J Psoter
- Department of Pediatrics, Johns Hopkins University, School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA
| | - Andrea Goodman
- Department of Medicine, Johns Hopkins University, School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA
| | - Emma McWilliams
- Department of Pediatrics, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Carla Frederick
- Department of Pulmonary Medicine, University at Buffalo, 100 High St. B-8, Buffalo, NY 14203, USA
| | - Carlos Milla
- Department of Pediatrics - Pulmonary Medicine, Stanford University, 770 Welch Rd Suite 350, Stanford, CA 93405, USA
| | - Gabriela Oates
- Department of Pediatrics, 1600 7th Avenue South, Lowder 620, Birmingham, AL 35233, USA
| | - Gregory S Sawicki
- Department of Pediatrics, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Kristin A Riekert
- Department of Medicine, Johns Hopkins University, School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA
| |
Collapse
|
2
|
Orozco-Solano S, Silva-Castro MM, Machuca M. [Translated article] Medication experience and clinical interventions in patients receiving pharmaceutical care: A scoping review of pharmaceutical care practice. FARMACIA HOSPITALARIA 2023; 47:T230-T242. [PMID: 37659906 DOI: 10.1016/j.farma.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 04/04/2023] [Accepted: 04/26/2023] [Indexed: 09/04/2023] Open
Abstract
OBJECTIVE Analyze scientific literature on qualitative research that studies the medication experience-MedExp-and related pharmaceutical interventions that bring changes in patients' health. Through the content analysis of this scoping review, we intend to: (1) understand how pharmacists analyze the MedExp of their patients who receive Comprehensive Medication Management CMM and (2) explain which categories they establish and how they explain the individual, psychological, and cultural dimensions of MedExp. METHODS The scoping review followed recommendations from PRISMA Extension for Scoping Reviews. Medline (Pubmed), SCOPUS, Web of Science, and Psycinfo were used to identify research on MedExp from patients attended by pharmacists; and that they comply with quality standards, Standards for Reporting Qualitative Research. Articles published in English and Spanish were included. RESULTS 395 qualitative investigations were identified, 344 were excluded. In total, 19 investigations met the inclusion criteria. Agreement between reviewers, kappa index 0.923, 95% CI (0.836-1.010). The units of analysis of the patients' speeches were related to how they were progressing in their medications and how it was built through MedExp, the influence it has on the experience of becoming ill, the connection with socioeconomic aspects, and beliefs. Based on MedExp, the pharmacists raised cultural proposals, support networks, health policies, and provide education and information about medication and disease. Additionally, characteristics of the interventions were identified, such as a dialogic model, therapeutic relationship, shared decision-making, comprehensive approach, and referrals to other professionals. CONCLUSIONS The MedExp is an extensive concept, which encompasses people's life experience who use medications based on their individual, psychological, and social qualities. This MedExp is corporal, intentional, intersubjective, and relational, expanding to the collective because it implies beliefs, culture, ethics, and the socioeconomic and political reality of each person located in their context.
Collapse
Affiliation(s)
- Sofía Orozco-Solano
- Centro de Información de Medicamentos, Unidad de Optimización de la Farmacoterapia, Servicio de Farmacia, Hospital Dr. R.A. Calderón Guardia, San José, Costa Rica.
| | | | - Manuel Machuca
- Departamento de Ciencias Biológicas y de la Salud, Facultad de Ciencias de la Salud, Universidad Loyola, Dos Hermanas, Sevilla, Spain.
| |
Collapse
|
3
|
Orozco-Solano S, Silva-Castro MM, Machuca M. Medication experience and clinical interventions in patients cared for by pharmacist: Scoping review of pharmaceutical care practice. FARMACIA HOSPITALARIA 2023; 47:230-242. [PMID: 37302918 DOI: 10.1016/j.farma.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 04/04/2023] [Accepted: 04/26/2023] [Indexed: 06/13/2023] Open
Abstract
OBJECTIVE Analyze scientific literature on qualitative research that studies the medication experience -MedExp- and related pharmaceutical interventions that bring changes in patients' health. Through the content analysis of this scoping review, we intend to: 1) understand how pharmacists analyze the MedExp of their patients who receive Comprehensive Medication Management and 2) explain which categories they establish and how they explain the individual, psychological and cultural dimensions of MedExp. METHODS The scoping review followed recommendations from PRISMA Extension for Scoping Reviews. Medline (Pubmed), SCOPUS, Web of Science, and Psycinfo were used to identify research on MedExp from patients attended by pharmacists; and that they comply with quality standards, Standards for Reporting Qualitative Research. Articles published in English and Spanish were included. RESULTS 395 qualitative investigations were identified, 344 were excluded. In total, 19 investigations met the inclusion criteria. Agreement between reviewers, kappa index 0.923 95% CI (0.836-1.010). The units of analysis of the patients' speeches were related to how they were progressing in their medications and how it was built through MedExp, the influence it has on the experience of becoming ill, the connection with socioeconomic aspects, and beliefs. Based on MedExp, the pharmacists raised cultural proposals, support networks, health policies, and provide education and information about medication and disease. Additionally, characteristics of the interventions were identified, such as a dialogic model, therapeutic relationship, shared decision-making, comprehensive approach, and referrals to other professionals. CONCLUSIONS The MedExp is an extensive concept, which encompasses people's life experience who use medications based on their individual, psychological and social qualities. This MedExp is corporal, intentional, intersubjective and relational, expanding to the collective because it implies beliefs, culture, ethics and the socioeconomic and political reality of each person located in their context.
Collapse
Affiliation(s)
- Sofía Orozco-Solano
- Centro de Información de Medicamentos, Unidad de Optimización de la Farmacoterapia, Servicio de Farmacia, Hospital Dr. R.A. Calderón Guardia, San José, Costa Rica.
| | | | - Manuel Machuca
- Departamento de Ciencias Biológicas y de la Salud, Facultad de Ciencias de la Salud, Universidad Loyola, Dos Hermanas, Sevilla, España
| |
Collapse
|
4
|
Patient Perspectives on the Use of Digital Technology to Help Manage Cystic Fibrosis. Pulm Med 2023; 2023:5082499. [PMID: 36727045 PMCID: PMC9886457 DOI: 10.1155/2023/5082499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 10/24/2022] [Accepted: 11/12/2022] [Indexed: 01/25/2023] Open
Abstract
Background Digital health technologies (DHTs) have shown potential to improve health outcomes through improved medication adherence in different disease states. Cystic fibrosis (CF) requires care coordination across pharmacies, patients, and providers. DHTs can potentially support patients, providers, and pharmacists in diseases like CF, where high medication burden can negatively impact patient quality of life and outcomes. Methods In this prospective cohort study, a CF-specific mobile application (Phlo) was distributed to adults with CF who received care at the University of Utah Cystic Fibrosis Center, used an iPhone, and filled prescriptions through the University of Utah Specialty Pharmacy services. Participants were asked to use Phlo for 90 days with an optional 90-day extension period. Participants completed four surveys at baseline and after 90 days. Changes in patient-reported outcomes, adherence, clinical outcomes, and healthcare resource utilization from baseline to 90 days were tracked. Results Phlo allowed users to track daily regimen activities, contact their care team, receive medication delivery reminders, and share progress with their healthcare team. A web-based dashboard allowed the care team to review reported performance scores from the app. Most patients (67%) said the app improved confidence in and motivation for continuing their regimen. The most important reported benefit of Phlo was having a single location to manage their whole routine. Conclusions Phlo is a mobile health technology designed to help patients with CF manage their treatment regimen and improve patient-provider communication.
Collapse
|
5
|
Abraham O, Buechel M, Gay S, Szela L, Decker CA, Braun AT. Using A Work System Framework to Investigate Pharmacists' Roles in Cystic Fibrosis Management. J Pediatr Pharmacol Ther 2022; 27:270-276. [PMID: 35350161 DOI: 10.5863/1551-6776-27.3.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/23/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Cystic fibrosis (CF) is a genetic disease that requires complex, lifelong treatment regimens to maintain health and reduce disease progression. The aims of this study were 1) to gain the perspectives of multiple health professions to understand medication and well-being challenges of people living with CF; and 2) to apply the Systems Engineering Initiative for Patient Safety (SEIPS) model to further identify opportunities for pharmacists to support people with CF. METHODS Health care professionals were recruited from a Cystic Fibrosis Center in the Midwest, to participate in audio-recorded semistructured interviews. Topics examined during the interviews included medication education for patients as well as experiences with outpatient, specialty, and community pharmacists. The themes assessed during the pharmacist interviews included support for people living with CF, preferences in conducting medication education, and pharmacist-specific counseling. Interview transcripts were thematically analyzed into categories to determine major themes. Prevalent codes were categorized into 5 major themes guided by the SEIPS model. Interrater reliability was strong (kappa = 0.94). RESULTS Five major themes were identified: 1) patient tasks; 2) external environment; 3) organizational conditions; 4) patient medication education; and 5) pharmacists' roles and tasks. Professionals identified the importance of the pharmacist on the multidisciplinary CF care team to enhance patient-centered care for people living with CF. CONCLUSIONS This study highlights health care professionals' views on the unique skillset that pharmacists add to the care team, including a reduction in medication errors, improved adherence, and overall enhanced patient care.
Collapse
Affiliation(s)
- Olufunmilola Abraham
- University of Wisconsin-Madison School of Pharmacy, Social and Administrative Sciences Division (OA, MB, SG, LS), Madison, WI
| | - Megan Buechel
- University of Wisconsin-Madison School of Pharmacy, Social and Administrative Sciences Division (OA, MB, SG, LS), Madison, WI
| | - Sommer Gay
- University of Wisconsin-Madison School of Pharmacy, Social and Administrative Sciences Division (OA, MB, SG, LS), Madison, WI
| | - Lisa Szela
- University of Wisconsin-Madison School of Pharmacy, Social and Administrative Sciences Division (OA, MB, SG, LS), Madison, WI
| | - Catherine A Decker
- School of Medicine and Public Health, University of Wisconsin-Madison (ATB, CAD), Madison, WI
| | - Andrew T Braun
- School of Medicine and Public Health, University of Wisconsin-Madison (ATB, CAD), Madison, WI
| |
Collapse
|