Our evolving prescribing practice: inhaled medication prescription changes over 5 years at the West Midlands Adult Cystic Fibrosis Centre

ABSTRACT

Background: Highly effective modulator therapy (HEMT) is now available for ∼90% of adults with CF with Kaftrio® licenced for use in the UK from August 2020. Despite continuation of routine CF treatments in randomised controlled trials, real-world evidence suggests a reduction in prescribed inhaled medication for people with CF on HEMT.1 Alongside the introduction of Kaftrio®, additional factors have impacted upon our inhaled medication prescribing practice including the COVID-19 pandemic and the introduction of CFHealthHub, which allows us to monitor nebulised treatment adherence. Objective: To examine how and to what extent our inhaled medication prescribing practice has changed over the past 5 years. Method: A retrospective audit of our prescribed inhaled medication databases from 2016, 2019 and 2021. Results: See table 1. Table 1. Number of CF patients prescribed inhaled mucolytics and long term inhaled therapy for Pa. (Table Presented) Conclusion: Despite an increasing rate of Pa infection,we have observed an overall reduction in prescribing of inhaled antibiotics and mucolytics. HEMTs, particularly Kaftrio®, have improved the health of our patients and, despite our caution, many have requested a reduction of inhaled therapy in line with their improved well-being. Assessment of adherence via CFHealthHub has often led to rationalisation of inhaled treatments in order to support improved adherence. During the COVID-19 pandemic, drug response assessments, the gateway to accessing a change in inhaled medication, have frequently been delayed as we have had to redesign our service in response to changing circumstances.