Virtual medication tour with pharmacist as part of cystic fibrosis telehealth visit

Introduction: Pharmacist-patient interactions via telehealth have been described in rural settings (Littauer SL, et al Pharm Pract 2017;15(4):1134), long-term care (Kane-Gill SL, et al Consult Pharm 2017;32(2):93-8), and other populations As institutions adapted to the COVID-19 pandemic, innovative solutions were needed, and pharmacists were incorporated into telehealth more broadly (Elson EC, et al AJHP 2020;77(13):1005-6) In April, we transitioned a majority of appointments to telehealth The CF team pharmacist maintained current standards of care, but incorporated a “virtual medication tour” utilizing this new technology to provide a service usually only available via home health visits Methods: Patients 18 years and older were asked by the pharmacist to provide a virtual tour of their medications during the visit They were prompted to show areas of the home where medications were stored The pharmacist evaluated whether or not storage conditions were appropriate This included determining if medications were within reach of children, and appeared to be stored appropriately in regards to temperature, humidity, and light exposure The primary outcome was to determine patient willingness to participate in virtual medication tours The secondary outcome was to identify potential interventions that could be achieved by incorporating this practice Results: Of 20 patients seen via telehealth for a CF clinic appointment between April and June 2020, 13 patients were willing to participate in a virtual medication tour Through this process, we found 3 of 4 participating patients with a child under 12 years old had medications stored in a place accessible to children All patients had their medications stored at the correct temperature Only one patient had a medication stored inappropriately based on potential light exposure Overall, 86 4% of patients had some style of pill organizer, either store-bought or homemade, as part of their medication storage strategy Information about one or more OTC products or supplements was missing from the medication list at the start of 25% of telehealth visits A virtual medication tour allowed for resolution of this information 80% of the time Other discrepancies between the medication list and home medication regimen were identified during only one visit Discussion: Our initial findings demonstrate that a virtual medication tour led by a pharmacist can be successfully incorporated into telehealth visits, and was accepted by a majority of patients Of those who did not participate, most attributed this to being in an alternate location during the telehealth visit, such as office or workplace, or quarantining at another household during the COVID-19 pandemic where they felt medication storage did not accurately reflect their usual practices or habits Based on pharmacist observations during virtual medication tours, most patients were already properly storing medications for stability, but might benefit from targeted education on variation of temperature within refrigerators, light sensitivity of certain medications, and ability of children or pets to inappropriately gain access to supplies We plan to offer a poison prevention education day via webinar to patients and families later this year based on these findings