Outcomes of a Pharmacist-Led Hepatitis C Virus Treatment Program in an Urban Safety-Net Health System, Chicago, 2017-2019

Abstract

Objective A recommendation in March 2020 to expand hepatitis C virus (HCV) screening to all adults in the United States will likely increase the need for HCV treatment programs and guidance on how to provide this service for diverse populations. We evaluated a pharmacist-led HCV treatment program within a routine screening program in an urban safety-net health system in Chicago, Illinois. Methods We collected data on all patient treatment applications submitted from January 1, 2017, through June 30, 2019, and assessed outcomes of and patient retention in the treatment cascade. Results During the study period, 203 HCV treatment applications were submitted for 187 patients (>1 application could be submitted per patient): 49% (n = 91) were aged 55-64, 62% (n = 116) were male, 67% (n = 125) were Black, and 15% (n = 28) were Hispanic. Of the 203 HCV treatment applications, 87% (n = 176) of patients were approved for treatment, 91% (n = 161) of whom completed treatment. Of the 161 patients who completed treatment, 81% (n = 131) attended their sustained virologic response (SVR) follow-up visit, 98% (n = 129) of whom reached SVR. The largest drop in the treatment cascade was the 19% decline from receipt of treatment to SVR follow-up visit. Conclusion The pharmacist-led model for HCV treatment was effective in navigating patients through the treatment cascade and achieving SVR. Widespread implementation of pharmacist-led HCV treatment models may help to hasten progress toward 2030 HCV elimination goals.

User experience of a hepatitis c population management dashboard in the Department of Veterans Affairs

“…Generally, MDs and Advanced Practice Providers used the birth cohort screening reports most frequently, PharmDs the linkage and potential treatment reports, and RNs the SVR report. This use pattern reflects the rapidly changing roles in the first years of DAA implementation [ 18 , 19 ]. As others have reported, clinical pharmacists and advanced practice providers were central to DAA treatment initiation in recent years [ 20 , 21 ].…”

Adherence to Hepatitis C Treatment Among Underserved Patients With Substance Use Disorder in a Pharmacist-led Treatment Model

“…This is consistent with previous studies demonstrating improved outcomes and adherence with pharmacist-led models of care for vulnerable populations with chronic HCV infection. 16,17 Additionally, having a pharmacy located within the primary care clinic increased the likelihood of patients initiating treatment. In the absence of an in-house pharmacy, and given the high cost of DAA regimens, other clinics and providers would require means for DAA acquisition potentially including a mail order specialty pharmacy for medication processing and delivery.…”

Hepatitis C virus screening in community pharmacies: results on feasibility from a Swiss pilot

“…Likewise, Hunt and colleagues described a pharmacist-led HCV programme in Chicago, which involves (clinical) pharmacists reviewing patient records, selecting treatment regimens, acquiring insurance approval, educating patients on adherence, and monitoring treatment effectiveness within a collaborative team at an infectious disease clinic. Here, pharmacists effectively led patients through the treatment cascade after a universal screening programme [ 23 ]. Similarly, Downes and colleagues described the effectiveness of clinical pharmacist-led HCV treatment management at a health centre in Omaha.…”