Impact of a Nurse Care Coordinator Supporting a Clinical Pharmacist Practitioner in Further Managing HCV-Infected Patients

Abstract

Patients undergoing chronic hepatitis C treatment require monitoring to ensure that treatment is both safe and effective. However, many of these patients are lost to follow-up. The aim of this study was to investigate the impact of implementing a Nurse Care Coordinator's role in a pharmacy-based collaborative team to enhance the care of hepatitis C-infected patients. This was a 6-month retrospective chart review from July 2018 to January 2019, where 116 patients receiving hepatitis C treatment were referred to the Nurse Care Coordinator for further management. The Nurse Care Coordinator provided more than a 5-fold increase in contact method by telephone call. Of the 116 referred hepatitis C-infected patients, 44.8% (n = 52) of patients were referred due to a missed post-treatment Week 12 follow-up appointment to assess for cure. The Nurse Care Coordinator successfully rescheduled 96.2% (50/52) of follow-up appointments to assess for cure; 90% (45/50) of those patients adhered to scheduled appointment; and 97.8% (44/45) of patients had undetectable hepatitis C virus RNA, indicating cure. The primary success rate of the intended Nurse Care Coordinator arrangement was 97.4% (n = 113), where 89.4% (101/113) of patients successfully adhered to the intervention. This study demonstrates the positive impact the Nurse Care Coordinator had in successfully re-engaging previously lost to follow-up patients back into clinic.