Better outcomes for CF patients in monitoring program

Cystic fibrosis (CF) patients have better outcomes when they are enrolled in a pharmacy-based comprehensive therapy management program, according to a study presented at the 30th Annual North American Cystic Fibrosis Conference (NACFC) in Orlando, Florida.

The study, from Walgreens and Avalere – an Inovalon company, examined the effectiveness of the Walgreens Connected Care CF program compared to a matched sample of control patients. This retrospective cohort study used administrative medical and pharmacy claims data from Inovalon’s MORE2 database. Propensity-matching and multivariate regression were used to make the intervention and control groups more comparable.

Patients in the intervention group were found to have significantly higher medication adherence, fewer ER visits and lower ER costs. Other outcomes, e.g., total medical costs, hospitalizations, and pulmonary exacerbations, all favored the program sample, but did not achieve statistical significance.

“Statistically significant results included higher adherence to inhaled tobramycin and fewer ER visits for Walgreens program patients compared to matched, non-Walgreens controls,” says study author Heather Kirkham, director, health analytics, research and reporting at Walgreens. “ER visits are an important marker for poor health outcomes and are often precursors to even more expensive utilization such as hospitalizations. ER costs for program participants were 34% lower, relative to their matched controls.”  

According to Kirkham, there are pros and cons to pharmacy-based programs.

“For example, pharmacies can help support patients between visits to their CF care centers and physicians,” he says. “Pharmacists are in a unique position to identify barriers to adherence such as side-effects or clinical precursors to exacerbations. A con is pharmacists are often a underutilized resource in the clinical care team-not just in CF but also many other disease states.”

Kirkham has seen costs savings in other recent studies for patients on immunoglobulin and various chronic medications who were managed in pharmacy-based management programs.

Based on the study, Kirkham shares three takeaways:

1.  Poor adherence among cystic fibrosis patients is common and can lead to poor outcomes.

2.  Pharmacy-based therapy management programs can help increase adherence and decrease inappropriate utilization such as ER visits. 

3.  Pharmacies that provide enhanced clinical services such as therapy management can be an add-on layer of support to managed care teams.