Original Research
Monday, November 13, 2023
01:00 PM–02:30 PM
Abstract
Introduction: There are few reported outcomes regarding pediatric asthma treatment at federally qualified health centers (FQHC). FQHC patients are considered high-risk with complex social determinants of health. This FQHC, located in Sumter, South Carolina, has an established collaborative practice agreement for pharmacist-led management of pediatric asthma.
Research Question or Hypothesis: Direct inclusion of a pharmacist in the interprofessional team will have a positive impact on asthma control in high-risk pediatric patients.
Study Design: Single-center, retrospective, observational cohort study
Methods: Patients were included if they had a current asthma diagnosis, aged 4-21 years old, and were an active patient of the FQHC. Patients were referred to the pharmacist-led asthma clinic to receive disease state and medication device education with guideline-directed asthma pharmacotherapy changes when needed. Patients and caregivers were surveyed with age-appropriate asthma control tests (ACT) before the first asthma clinic appointment and at each follow-up visit. The primary endpoint was the change in ACT score from baseline before pharmacist intervention to most recent follow up, where a change of 2-3 points has been validated as a clinically meaningful difference. Secondary endpoints included proportions of: patients who achieved a clinically meaningful increase in ACT, usage of systemic corticosteroids or emergent care, and patients converted to utilizing the FQHC's on-site pharmacy. Continuous endpoints were evaluated using paired t-tests and categorical variables with Fisher’s exact tests.
Results: Thirteen patients were enrolled with an average age of 11.8 years and 4.4 years since asthma diagnosis. Pharmacist intervention showed a statistically significant improvement in the primary endpoint (mean±SD ACT score increase 6.077±3.068; p<0.001). All patients had a clinically meaningful improvement in asthma control. One patient (7.69%) sought emergent care including systemic corticosteroid usage. Among eligible patients, 4 of 5 (80%) were converted to utilizing the on-site pharmacy.
Conclusion: Pharmacist intervention improved asthma control in high-risk pediatric patients within an FQHC.
Presenting Author
Kaitlyn Phillips PharmDTandem Health - University of South Carolina College of Pharmacy
Authors
P. Brandon Bookstaver PharmD
University of South Carolina College of Pharmacy
Reagan K. Barfield PharmD
University of South Carolina College of Pharmacy
David Turell MD
Tandem Health
Carrington Royals PharmD
Tandem Health, Inc.