IMPACT OF A CLINICAL PHARMACIST AND SPECIALTY PHARMACY SERVICES ON TREATMENT OUTCOMES IN AN IDIOPATHIC PULMONARY FIBROSIS SPECIALITY CLINIC

Abstract

TOPIC: Diffuse Lung Disease TYPE: Original Investigations PURPOSE: Evaluate the impact of an idiopathic pulmonary fibrosis (IPF) clinical pharmacist and specialty pharmacy services on patient outcomes. METHODS: This is a retrospective chart review evaluating patients prescribed anti-fibrotic treatment with nintedanib (Ofev®) or pirfenidone (Esbriet®) at an interstitial lung disease (ILD) specialty clinic from the period of 9/2016-1/2021. Clinical outcomes evaluated include time to treatment discontinuation, adverse event management, and markers of IPF progression. Non-clinical outcomes including assessment for appropriate adherence as indicated by proportion of days covered (PDC) of ≥80%, time to anti-fibrotic treatment initiation following pharmacy receipt of prescription (turnaround time), patient financial obligation, and financial assistance provided will also be evaluated. Data will be summarized using descriptive statistics and compared to available data from anti-fibrotic clinical trials, internal data, and other relevant literature. RESULTS: Chart review for this research is in process as of current. Preliminary results suggest that most patients managed by the IPF pharmacist and specialty pharmacy (n = 31) with 3 or more anti-fibrotic prescription fills maintained appropriate adherence as evidenced by a PDC ≥80% in 83% (n = 26) of patients. Patients with a PDC of <80% (n = 5) were reviewed for clinically appropriate reasons for exclusion with 60% (n = 3) ultimately being excluded from PDC calculation for having a clinically appropriate reason for non-adherence. The average prescription turnaround time was 1.94 days (range 1-13 days). Data will be reviewed to obtain additional outcomes as indicated in the methods section and is expected to be completed ~6/2021. CONCLUSIONS: Though this chart review is still in process, preliminary results from anti-fibrotic dispensing data indicate that the majority (92.8%) of patients achieved appropriate adherence to medication therapy with a PDC of ≥80% following exclusion for clinically appropriate reasons for non-adherence such as medication adjustment for toxicity. Additionally, results showed that patients who receive anti-fibrotic prescriptions through the internal specialty pharmacy generally received their medications in 2 days or less, indicating only minimal delays in treatment initiation. Though data review is not final as of current, preliminary review suggests that patients who were not managed by the internal specialty pharmacy and IPF pharmacist were more likely to have a PDC of <80%, indicating potential issues with adherence in this population. Further data review will elucidate the benefits of including an IPF-focused clinical pharmacist and integrated specialty pharmacy in the multi-disciplinary management of IPF patients. CLINICAL IMPLICATIONS: Results will be used to aid in elaborating on the role of an IPF-focused clinical pharmacist in the multi-disciplinary management of IPF patients, lead to further generalized research into the impacts of a pharmacist within an ILD/Pulmonary clinic, and will highlight the importance of collaboration between an IPF-focused clinical pharmacist and an integrated health-system specialty pharmacy. DISCLOSURES: No relevant relationships by Charles Bodreau, source=Web Response No relevant relationships by Said Chaaban, source=Web Response No relevant relationships by Stephen Hobbs, source=Web Response No relevant relationships by Thom Platt, source=Web Response