Efficacy of Problem-Solving Intervention to Improve Adherence in Adolescents and Adults with Cystic Fibrosis

Background: Adherence to treatment by adolescents and adults with cystic fibrosis (CF) is often poor. Objectives: To assess the impact of a focused clinical intervention on adherence in individual patients, including help in problem-solving key barriers to adherence. To implement a patient-centered problem-solving intervention using CF My Way tools. To identify and overcome a selected barrier to adherence. Methods: Medication possession ratios (MPRs), number of airway clearance sessions, forced expiratory volume (FEV,), body mass index (BMI), and health-related quality of life (HRQoL) were measured before and after the intervention. Results: Sixteen patients with CF, aged 23.4 +/- 6.7 years, participated. MPR increased for col istimethate sodium and tobramycin inhalationsfromamedian of 21 (range 0-100) to 56 (range 0-100), P = 0.04 and 20 (range 0-100) to 33.3 (range 25-100), P = 0.03, respectively. BMI standard deviation score rose from -0.37 to -0.21, P = 0.05. No significant improvements were found in FEV,, airway clearance, or HRQoL scores. Conclusions: The CF My Way problem-solving intervention increased adherence to medical treatments by removing barriers directly related to the needs and goats of young adults with CF.

Automated summary

A focused clinical intervention aimed at problem-solving key barriers to adherence increased medication possession ratios and BMI in cystic fibrosis patients. However, no significant improvements were observed in FEV, airway clearance, or HRQoL. The intervention was effective in addressing specific barriers related to the needs and goals of young adults with CF.