Contributions of a pharmacist to annual reviews in a UK paediatric cystic fibrosis team

Abstract

Objectives: This study was conducted to assess the contributions of a specialist pharmacist to the care of children with Cystic Fibrosis (CF) during annual review (AR) clinics, as recommended by ECFS standards of care. The paediatric CF centre involved serves 86 patients aged 0-17, with a 0.6 whole time equivalent specialist pharmacist attending fortnightly AR Clinics. Method(s): Over 11 months, AR notes were reviewed, focusing on a random sample of 13 patients across age groups and care settings. Result(s): Out of 72 patients scheduled for AR, 64 (89%) attended, and 54 (75%) were seen by the pharmacist. Reasons for missed pharmacist consultations included annual leave (5 patients, 2 clinics), AR held in segregated clinics (n=3) or at the shared care centre (n=2), AR held during admissions (n=3), and patients leaving without consultation. Most patients (51/54) were seen within one year, but three had gaps of two or more years. In the sample of 13 patients, prescribed an average of 10 (5-16) regular medicines, the pharmacist documented 43 contributions, mean 3.3 per patient. Contributions included adverse drug reaction management (n=8), behavioural interventions (n=5), deprescribing (n=5), medicines reconciliation (n=5), prescription review (n=4), medication access (n=3), patient/family education (n=3), therapeutic adjustments (n=3), and other interventions (n=7). The majority focused on CFTR modulators (12/43) and antibiotics (10/43). Outcomes included changes in prescriptions (11/43), deprescribing (4/43), and monitoring tests (11/43). Deprescribing cost savings of over 30,000 per annum were identified across 8/13 patients primarily by stopping nebulised antibiotics. Conclusion(s): Pharmacist contributions enhance safety of patient care and optimize medication regimens. Cost effectiveness of investing in pharmacy services was demonstrated. Barriers to delivering AR, such as clinic availability, could be addressed through better scheduling or virtual consultations. Copyright © 2025