ECFC Brussels - June 2015 A nurse specific monitoring for CF patients taking ivacaftor (Kalydeco) A nurse specific monitoring for CF patients taking ivacaftor (Kalydeco TM ) M.Kerbrat 1, R.Fretay 2, D.Chevalier 3, F.You 3, M.Chiffoleau 4, A.Hubault 4, C.Matras 5,I.Berhault 6, MT.Jousseaume 6, MC.L’Abbé 6, C.Pingon 6, MC.Quillevere 7, S.Paul 7, K.Sery 8, M.Idres 9 1 CF reference centre Nantes-Roscoff, France; 2 CF centre Vannes-Lorient, France; 3 CF centre Nantes, France; 4 CF centre Angers, France; 5 CF centre Tours France; 6 CF centre Rennes, France; 7 CF centre Roscoff, France; 8 St Nazaire Hospital, France; 9 St Brieuc Hospital, France Acknowledgments to G.Rault 1 and S.Hugé 2 ECFC Brussels - June 2015
Context ► A French coordinator nurses’ CF network group representing 9 CF centres (average 1000 patients) ► 4 meetings a year to discuss nurses' practices, improve patient support, build and innovate together ► One in 2014, focused on ivacaftor (Kalydeco TM ) 25 CF patients, children (>6 years old) and adults with gating mutations, concerned by ivacaftor Represents a significant breakthrough Needs some administration conditions and long term compliance
ECFC Brussels - June 2015 Objectives ► To evaluate the ivacaftor-taking in daily life: feeling of efficacy compliance to ivacaftor drug administration conditions, side effects ► To highlight the potentials changes with ivacaftor in patients’ life: quality of life other treatments ► To improve nurses’ knowledge about ivacaftor and the optimal administration conditions
ECFC Brussels - June 2015 Methodology ► 1. Brainstorming: « What do we really know about ivacaftor?” ► 2. Material Quality of life questionnaires (CFQ-R and Satmed-Q Inserm) French questionnaire about compliance (« Auto questionnaire ACGT comment dire ») Booklets about Kalydeco TM ► 3. Creation of a nurse specific monitoring for patients taking ivacaftor and instructions (when, how to use it …) ► 4.Test, feedback and adjustments ► 5.Effective establishing on the network
ECFC Brussels - June 2015 The nurse specific monitoring for patients taking ivacaftor 2 questionnaires and Instructions
ECFC Brussels - June 2015
Results ► 18 completed questionnaires until now: Feeling of efficacy: ► And 12 feel good with it (12) ► But 8 do not see any difference (Young patients already with few symptoms) Compliance: ► They rarely forget the intake: 15/rarely and 3/sometimes ► All the patients want to continue the treatment Side effects: only a few (5) Changes: ► Some of them change usually treatment: decrease physiotherapy (4), pancreatic enzyme supplements (1), antibiotherapy (2), stop salt (2) and aerosol (1) Drug administration conditions: ► A patient does not eat in the morning and take on an empty stomach!
ECFC Brussels - June 2015 Discussion and conclusion ► Those questionnaires give clues for a long-term monitoring: Not to trivialize the importance of treatment, to recall the modalities To exchange and adapt the beside treatment To evaluate and preserve the long term compliance To appreciate globally the effects and the impact on patient life ► An approach, for the nurses, of educational tools of compliance, self-efficacy and quality of life ► A question: How asymptomatic children will manage this long- lasting treatment without feeling of improvement? ► Those questionnaires could be improved and used for other specific upcoming treatments