Outcomes associated with antibiotic regimens for treatment of Mycobacterium abscessus in cystic fibrosis patients.

BACKGROUND: Mycobacterium abscessus infection is associated with declining lung function in cystic fibrosis (CF), but there is little evidence on clinical efficacy to guide treatment. METHODS: Retrospective review of 37 CF patients treated for M. abscessus respiratory infection at a single center from 2006 to 2014. Outcomes included change in FEV1 at 30, 60, 90, 180, and 365days after treatment and clearance of M. abscessus from sputum cultures. RESULTS: Lung function was significantly improved after 30 and 60days of treatment, but not at later time points. Gains were inversely related to starting lung function. Antibiotic choices did not influence outcomes except for greater clearance with clarithromycin. CONCLUSIONS: Treatment of M. abscessus resulted in short term improvement in lung function that is inversely related to pre-treatment FEV1.

Pharmacist-Led Model to Reduce Hospital Readmissions in Medically Complex Children.

OBJECTIVES: This pilot study investigated the feasibility and effect on health care utilization of medically complex children participating in a pharmacist-led model for care coordination. Quality of life and satisfaction with care were secondarily assessed for each patient. METHODS: Four medically complex children were enrolled and contacted by the pharmacist weekly for 5 consecutive months. Time for each encounter with a patient was collected. Each patient's hospital admissions, days of stay, emergency department visits, and clinic visits were recorded. At enrollment and at the end of the study, each caregiver completed the PedsQL 4.0 questionnaire to evaluate the child's quality of life and the Patient Assessment of Care for Chronic Conditions questionnaire to assess satisfaction with care. Patients aged 5 years and older completed an age-appropriate version of the PedsQL 4.0 as well. RESULTS: The pharmacist spent on average 60 to 80 minutes per patient per week. Hospital admissions and days of stay decreased for 3 patients and increased for 1 patient during this study. Quality of life increased for 2 patients and decreased for 2 patients and satisfaction with care increased for all 4 caregivers. CONCLUSIONS: This model was feasible for a pharmacist to coordinate and required frequent physician involvement. Health care utilization varied between patients, but overall decreased for the 4 patients pooled. Changes in quality of life varied and may be attributed to using a survey that was not specific to medically complex children. Overall, caregivers were highly satisfied with this service and the health care their child received.

A consumer-led intervention to improve pharmacists' attitudes toward mental illness.

INTRODUCTION: Individuals with a severe and persistent mental illness often manage complex medication regimens and would benefit from support and education from their pharmacist. Past research has shown that community pharmacists have negative attitudes toward mental illnesses, and these attitudes affect willingness to provide services to patients with mental illnesses. Consumer-led interventions have shown benefit to improve student attitudes toward mental illness. However, there are no known studies showing the benefit of consumer-led educational programs to improve pharmacist attitudes toward mental illness and willingness to provide services to those with mental illnesses. The aim of this study is to determine the effects of a consumer-led continuing education program on pharmacists' attitudes toward and willingness to provide services to consumers with mental illnesses. METHODS: Fifty pharmacists participated in the program with 2 parts: discussion on the history of mental health care and consumers sharing their experiences. Pharmacists completed 1 survey before and after the program. Surveys asked about pharmacists' attitudes toward mental illness and willingness to provide services to individuals with schizophrenia compared to asthma. Data were analyzed using descriptive and paired t tests. RESULTS: Paired t tests showed a significant decrease in social distance and increase in positive attitudes and willingness to provide services to patients with mental illnesses immediately after the program. DISCUSSION: The immediate increase in positive attitudes and willingness to provide services to consumers with mental illnesses indicates that consumer-led interventions may be an effective way to improve the provision of pharmacy services to patients with mental illnesses.