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

Isr Med Assoc J. 2021 Sep;23(9):584-589.

Abstract

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 (FEV1), 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 colistimethate sodium and tobramycin inhalations from a median 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 FEV1, 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 goals of young adults with CF.

MeSH terms

  • Adolescent
  • Adult
  • Anti-Bacterial Agents / administration & dosage*
  • Body Mass Index
  • Colistin / administration & dosage
  • Colistin / analogs & derivatives
  • Cystic Fibrosis / drug therapy*
  • Female
  • Forced Expiratory Volume
  • Humans
  • Male
  • Medication Adherence / statistics & numerical data*
  • Patient-Centered Care / methods*
  • Problem Solving*
  • Quality of Life
  • Tobramycin / administration & dosage
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • colistinmethanesulfonic acid
  • Tobramycin
  • Colistin