Pharmacist-Managed Helicobacter pylori Treatment Service Within a Gastroenterology Clinic: Workflow and Real-World Experiences

Abstract

Background Treatment eradication rates of Helicobacter pylori, a gastrointestinal infection, are 70% to 90% in clinical studies but lower in real-world settings. Potential barriers include multidrug regimen complexity or prescribing/administration errors. A pharmacist-managed H pylori treatment service was implemented to address these barriers and optimize treatment outcomes. The clinical pharmacist provided 2 services: (1) treatment education and monitoring for treatment-naïve patients and (2) treatment initiation, education, and monitoring for treatment-experienced patients. Objective We aimed to evaluate the impact of a pharmacist-managed H pylori treatment service within a gastroenterology clinic. Methods We conducted a retrospective observational cohort study of all patients referred to and seen in the pharmacist-managed H pylori treatment service from July 10, 2019, to December 31, 2020. Patient demographics, prior treatment history, course(s) of treatment prescribed, frequency of follow-ups, and outcomes posttreatment were collected. Results The clinical pharmacist managed 60 referrals for 55 unique patients over a mean of 5 ± 2 visits. Five patients failed H pylori treatment and were re-referred. Identified barriers included prescribing/dispensing and administration errors. Posttreatment, 38 referrals tested for H pylori eradication, of which 100% of treatment-naïve patients and 69% of treatment-experienced patients were cured, and 13 (22%) referrals were lost to follow-up. Conclusion and Relevance This study described and assessed the impact of a pharmacist-managed H pylori treatment service in a gastroenterology clinic, in which various barriers were effectively addressed to optimize treatment outcomes. Future studies should focus on long-term outcome, impact on health care costs, and patient satisfaction with this service.

Treatment strategies and pharmacist‐led medication management for Helicobacter pylori infection

“…It is worth noting that the work of pharmacists also emphasizes to participate in the drug treatment process of in patients, implement pharmaceutical care, medication education, treatment effectiveness evaluation, and persistent medication management after discharge. Pharmacist‐managed H. pylori treatment service could effectively address the identified barriers including incorrect prescribing of treatment regimen by providers and incomplete dispensing of prescribed regimen by pharmacies, poor understanding of treatment regimen by patients, treatment nonadherence, and inadequate management of adverse effects (Bhat & Nunes, 2022). Finally, the pharmacist‐managed H. pylori treatment service obtained 100% eradication rate in patients who were never treated for H. pylori , and 69% eradication rate in patients who were defined as having failed at least 2 prior treatments without successful eradication of H. pylori (Bhat & Nunes, 2022).…”

“…Pharmacists in hospitals are mainly responsible for the examination and deployment of doctors' prescriptions, ensuring drug supply, providing medication consultation to patients and guiding the rational use of drugs. It is worth noting that the work of pharmacists also emphasizes to participate in the drug treatment process of in patients, implement pharmaceutical care, medication education, treatment effectiveness evaluation, and persistent medication management after discharge.Pharmacist-managed H. pylori treatment service could effectively address the identified barriers including incorrect prescribing of treatment regimen by providers and incomplete dispensing of prescribed regimen by pharmacies, poor understanding of treatment regimen by patients, treatment nonadherence, and inadequate management of adverse effects(Bhat & Nunes, 2022). Finally, the pharmacist-managed H. pylori treatment service obtained 100%…”