Photo Credit: Drazen Zigic
Clinical pharmacist IBD counseling reduced the occurrence and severity of anti-TNF adverse reactions and increased satisfaction in patients with IBD.
Additional counseling by clinical pharmacists reduced the occurrence and severity of anti-tumor necrosis factor (anti-TNF) adverse drug reactions and increased satisfaction in patients with inflammatory bowel disease (IBD), according to a study published in Inflammatory Bowel Diseases.
“Clinical pharmacists should be a part of a multidisciplinary team to improve holistic care of patients with IBD,” wrote Johannes Plechschmidt, PhD, and study coauthors.
Although anti-TNF therapy has markedly improved the management of patients with IBD, adverse drug reactions include opportunistic infections, induction of autoimmune or demyelinating disorders, and skin reactions. The single-center trial investigated the effect of intensified clinical pharmacist counseling on adverse drug reactions over 12 months.
The prospective study randomly assigned 127 adults with IBD on anti-TNF therapy to additional clinical pharmacist counseling or conventional standard of care. Age, Montreal classification, anti-TNF treatment duration, and disease characteristics were similar.
Patients assigned to the intervention received 30-minute counseling by the clinical pharmacist at the study’s start and at months 3, 6, and 12. Sessions addressed the prevention and management of adverse drug reactions, medication, fatigue, and nutrition.
Over 12 months, the intervention group had significantly lower adverse drug reactions compared with the control group. Per patient per month, adverse drug reactions averaged 0.20 in the intervention group and 0.32 in the control group.
The risk for a grade greater than or equal to two adverse events (AE) was significantly lower in the intervention group compared with the control. The researchers reported a hazard ratio of 0.34.
The probability of complete resolution of drug-related AEs was significantly higher in the intervention group, with a hazard ratio of 2.02. Drug-related AEs worsened in the control group.
Patient-reported satisfaction with medication information was significantly higher: scores on the Satisfaction with Information about Medicines Scale averaged 14.82 in the intervention group and 11.60 in the control group.
“Our data support the recommendation that the implementation of a clinical pharmacist in the MDT [multidisciplinary team] of a tertiary care center is an appropriate intervention to substantially improve the comprehensive management of patients with IBD under anti-TNF therapy,” the researchers concluded.
