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

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 (FEV,), 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 col istimethate sodium and tobramycin inhalationsfromamedian 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 FEV,, 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 goats of young adults with CF.