Impact of a clinical pharmacist-led educational intervention on caregiver knowledge in a paediatric ambulatory rheumatology clinic

Background Juvenile idiopathic arthritis (JIA) is one of the most common childhood-onset rheumatic diseases in Asia. Given the chronic nature of JIA and the need to minimise long-term damage, polypharmacy is often required to quickly achieve and maintain remission. Furthermore, non-adherence to treatment can delay disease resolution and lead to poor outcomes. Reported reasons for non-adherence include inadequate understanding of the disease course and experiencing adverse effects of treatment, which may be addressed by an educational intervention. Objectives We aim to describe the development, implementation, and evaluation of a clinical pharmacist-led education program for JIA patients. Methods Newly diagnosed JIA patients and their caregivers with newly prescribed medications were enrolled into the pharmacist-led educational program. This was conducted using standardized education materials. Primary outcome was caregivers’ JIA knowledge pre and post counselling. Other outcomes were caregivers’ satisfaction, time spent and cost savings by patients. Results Fourteen responses were collected. Caregivers’ JIA knowledge score improved significantly from a median score of 5 (range 3-10) pre-counselling to 10 (range 6-10) post-counselling (p = 0.006). The service was well-received by caregivers (median satisfaction score of 32 (range 20-35)). Manpower costs for training and for the pharmacist to provide the service was 0.5 full-time employee. Each patient who underwent the pharmacist-led counselling potentially saved S$54-92. The pharmacist also contributed to education and research on rheumatology topics. Conclusion Pharmacist counselling improved caregivers’ JIA knowledge and potentially saved costs for JIA patients. Pediatric rheumatology centres should consider the inclusion of a clinical pharmacist in their team.