Implementation of a pharmaceutical care program for patients with hepatitis C treated with new direct-action antivirals

Int J Clin Pharm. 2019 Apr;41(2):488-495. doi: 10.1007/s11096-019-00809-3. Epub 2019 Apr 27.

Abstract

Background A pharmaceutical care program is necessary to improve the management of direct-acting antivirals in hepatitis C. Objective Describe health outcomes obtained with the implementation of a pharmaceutical care program in Hepatitis C patients treated with direct-acting antivirals. Setting This study was performed in a pharmacy department of a university hospital. Methods Retrospective study between 1st-April 2015 and 28st-February 2016. Hospital pharmacists implemented interventional measures for validation of antivirals prescriptions, detection of drug-interaction, adverse drug events, education and patient´s adherence to antiviral regimen. Main outcome measure Health and quality outcomes of the implementation of the pharmaceutical care program. Results A total 128 patients were enrolled. The overall sustained virologic response at week 12 post-treatment rate was 96.1% (95% CI 92.7-99.5). Adverse drug events occurred in 90.6% of the patients, and the majority were grade 1-2. Pharmacists made 334 pharmaceutical interventions. 35.5% of these interventions were aimed to resolve negative results of drugs. 80.9% of the negative results of drugs improved or were eliminated with the application of the measures proposed by the pharmacists (p ≤ 0.001). Pharmacists carried out 175 preventive interventions to avoid negative results of drugs. 97.3% of these interventions were accepted and managed to prevent the appearance of negative results of drugs (p = 0.453). Conclusion The implementation of a pharmaceutical care program in patients with hepatitis C treated with direct-acting antivirals has improved the safety in the use of these drugs.

Keywords: Antivirals; Chronic hepatitis C; Infectious diseases; Pharmaceutical care; Spain.

MeSH terms

  • Antiviral Agents / adverse effects
  • Antiviral Agents / therapeutic use*
  • Assessment of Medication Adherence
  • Drug-Related Side Effects and Adverse Reactions / prevention & control*
  • Female
  • Hepatitis C / drug therapy*
  • Hospitals, University / organization & administration
  • Humans
  • Male
  • Middle Aged
  • Pharmaceutical Services / statistics & numerical data*
  • Program Development / statistics & numerical data*
  • Quality Assurance, Health Care
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Antiviral Agents