EPS1.02 The impact of COVID-19 on the prescribing practice of specialist cystic fibrosis physiotherapist non-medical prescribers in the UK

Brown, C.; Archer, M.; Carson, L.; Collins, N.; Daniels, T.; Gates, A.; Johnstone, Z.; Patel, N.; Rashid, R.; Whitehouse, J. L.

Background: In the first wave of the COVID-19 pandemic, people with cystic fibrosis (pwCF) in the UK were asked to ‘shield’ at home whilst many specialist CF staff were redeployed. CF services had to rapidly adapt to the changing circumstances and traditional roles were blurred as services were redesigned to try to maintain quality CF care alongside minimising risk of COVID-19. Objective: To examine the impact of COVID-19 on the prescribing practice of CF physiotherapist non-medical prescribers (CFPT-NMPs) in the UK. Method: A bespoke online questionnaire was sent to all members of the ACPCF NMP group in July 2020. Results: 19/27 CFPT-NMPs completed the questionnaire (6 adults, 12 kids and 1 both). A greater proportion of adult CFPT-NMPs (6/6, 100%) than kids (3/12, 25%) or both (0/1, 0%) had been redeployed to non-CF areas. All reported COVID-19 had changed their prescribing practice, with an overall trend towards prescribing outside their CF speciality 5/8 (63%). In adults the trend was towards less frequent prescribing (4/5, 80%) with an increase in the different types of medication prescribed (3/4, 75%);in kids there was an increase in frequency of prescribing (7/10, 70%) but no trend in change of types of medication prescribed. 14/18 (78%) reported a delay or cessation in completing non-urgent drug response assessments (DRAs). The 22% of respondents reporting no delay in DRAs were working in kids. The 11/18 (61%) who had completed DRAs reported large variability within the DRA process, specifically around use of PPE and outcome measures. Conclusion: COVID-19 has significantly impacted the delivery of CF care and CFPT-NMP's prescribing practice. Many DRAs, the gateway to pwCF accessing appropriate inhaled medications, have been delayed. This was more likely in the adult population, highlighting the greater impact COVID-19 has had on adult CF services. COVID-19-specific DRA guidance has subsequently been produced by our ACPCF NMP group, facilitating timely and safe practice nationally.