Documentation practices of cystic fibrosis pharmacists: An opportunity for discipline-wide quality improvement.

BACKGROUND

As the pharmacists' role as part of cystic fibrosis (CF) care teams has expanded over the years and recently been redefined as "core" members, their effective electronic medical record (EMR) documentation contributes to clear and effective communication and continuity of care.

OBJECTIVES

This study aimed to evaluate current documentation practices and identify possible best practices and opportunities for standardization of pharmacists' documentation during CF clinic visits across centers.

METHODS

An electronic, deidentified survey was distributed to pharmacists via the CF Foundation listserv from January 10, 2023 to January 27, 2023. Survey items included multiple-choice questions and an option to upload pharmacist note templates. Two investigators reviewed the templates for common components, reconciling discrepancies with a third reviewer. Components of interest included recommendations, drug interactions, therapy monitoring, adherence assessment, substance screening, medication access and storage, guideline adherence, vaccination recommendations, CF transmembrane conductance regulator modulator eligibility/monitoring, exacerbation history, treatment plan coproduction, transitions of care, and education. Descriptive analysis used Stata SE 16.0.

RESULTS

Sixty pharmacists responded, with 94% practicing in the United States. Participants had varied CF care experience (1-10 years: 72.5%) and served pediatric (49%), adult (26.4%), and combined centers (24.5%). Most (84.6%) participated in joint provider visits, frequently in person or virtually (64%). Twenty-four EMR templates were collected, showing varied structures. Common elements were medication adherence and laboratory test results; less consistently included were drug interactions and coproduced goals.

CONCLUSION

Pharmacist EMR documentation at CF centers is highly variable. Defining best practices and incorporating coproduction of care could enhance clarity and continuity.