The clinical contribution of pharmacists to a sublingual immunotherpy (SLIT) service
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Authors
Hedzic Z.
Shah J.
Berkovitz, S.
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2025
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Article
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Objectives: To increase effectiveness and adherence to 3 years of SLIT and to relieve physicians of routine follow-up activity. Pharmacists are well-positioned to advise, counsel patients, and answer queries about indications, tablet administration and side effects of SLIT. Adherence and patient education are critical for success. Method(s): Pharmacists made telephone appointments for semi-structured follow-up reviews (30 minutes) Prior to appointments, patient questionnaires sent via hospital app (MyCare) or email Discuss any questions the patient may have during their review and document on EPIC electronic health record Maintain a Pharmacy tracker spreadsheet Send summary emails to physicians to reissue prescriptions and/or brief notes regarding adverse effects or ineffectiveness Results: 210 reviews since March 2024; 80 patients returned questionnaires before reviews; 14 patients lost to follow-up despite multiple attempted contacts; 25 patients definitely stopped therapy due to adverse effects; Mean improvement on GROC (Global Rating of Change) scale (0-7): House dust mite 4.0 (n = 39), grass pollen 4.5 (n = 21), tree pollen 3.3 (n = 6). Discussion(s): Supporting the RLHIM Allergy service has been a challenge for the Pharmacy team, involving learning how to use the EPIC clinical platform, make appointments, document notes, conduct telephone reviews and clinical evaluations change review schedules to better suit patients and manage the growing service ever more efficiently. Conclusion(s): Involvement of pharmacists in a SLIT service can improve adherence, monitoring and safety. Early detection of adverse events and collaboration with physicians can ensure correct prescription issuing and verification. Reducing physician follow-up workload increases new patient activity and reduces waiting lists. With increasing patient numbers, pharmacist time supporting the service has increased from 4 to 7 hours a week, but still provides additional value as well as improved pharmacy job satisfaction. Integrating pharmacists into allergy care teams can increase overall effectiveness and accessibility of SLIT.
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Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology