Pharmacist-led Management of Drug Therapy Effective for Patients With Hepatitis C

Pharmacist-led management of drug therapy proved effective for improving the treatment of patients with chronic hepatitis C infection (HCV) at a federally qualified health center, according to study findings published in the Journal of the American Pharmacists Association.

“HCV is challenging to address in those with barriers to accessing care, including patients from underserved populations,” wrote researchers. Linking at-risk patients through the HCV cascade of care can address … disparities by leveraging existing patient-provider relationships to identify and treat HCV. Pharmacists are ideal clinical team members to provide direct-acting antiviral (DAA) management given their expertise in pharmacotherapy and medication access.”

The observational study focused on pharmacist-led DAA management at OneWorld Community Health Centers, a federally qualified health center in Omaha, Nebraska.

Over a 4-year period, HCV screening in patients with identifiable risk factors increased from 8.0% to 67.5%, according to study authors. The improved screening was driven by a clinical reminder in the electronic health record, wrote researchers.

In patients with a detectible HCV load, 57.1% of patients in the pharmacist-led DAA management group received an order for DAA therapy documented in the electronic health record compared with 9.9% of patients in the usual care group.

Nearly 38% of patients, or 61 out of 162, referred to pharmacist-led DAA management initiated therapy. Some 57 patients completed therapy and had post-treatment viral load testing.

Of these, 54 patients had negative viral load results at the end of therapy, and 45 out of 46 had negative results 12 weeks after treatment. Researchers reported a treatment success rate of 97.8%, per sustained virologic response results.

“Of the patients receiving pharmacist-led DAA management, a majority who initiated and completed therapy were successfully cured of HCV .... While pharmacist-led DAA management did not directly affect HCV screening rates, it established the path to treatment in those who tested positive that was previously lacking,” stated researchers. “Combined, these efforts are helping OneWorld Community Health Centers successfully usher patients through the HCV cascade of care.”

Reference:
Downes JM, Donovan A, McAdam-Marx C. Pharmacist-led drug therapy management for hepatitis C at a federally qualified healthcare center. J Am Pharm Assoc. Published online April 26, 2022. doi:10.1016/j.japh.2022.04.014