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Expanding Hepatitis C Virus Care and Cure: National Experience Using a Clinical Pharmacist-Driven Model

dc.contributor.authorKoren, David E.
dc.contributor.authorZuckerman, Autumn
dc.contributor.authorTeply, Robyn
dc.contributor.authorNabulsi, Nadia A.
dc.contributor.authorLee, Todd A.
dc.contributor.authorMartin, Michelle T.
dc.identifier.citationDavid E Koren, Autumn Zuckerman, Robyn Teply, Nadia A Nabulsi, Todd A Lee, Michelle T Martin, Expanding Hepatitis C Virus Care and Cure: National Experience Using a Clinical Pharmacist–Driven Model, Open Forum Infectious Diseases, Volume 6, Issue 7, July 2019, ofz316,
dc.description.abstractBackground. The US National Viral Hepatitis Action Plan depends on additional providers to expand hepatitis C virus (HCV) treatment capacity in order to achieve elimination goals. Clinical pharmacists manage treatment and medication within interdisciplinary teams. The study's objective was to determine sustained virologic response (SVR) rates for clinical pharmacist-delivered HCV therapy in an open medical system. Methods. Investigators conducted a multicenter retrospective cohort study of patients initiating direct-acting antivirals from January 1, 2014, through March 12, 2018. Data included demographics, comorbidities, treatment, and clinical outcomes. The primary outcome of SVR was determined for patients initiating (intent-to-treat) and those who completed (per-protocol) treatment. Chi-square tests were conducted to identify associations between SVR and adverse reactions, drug-drug interactions, and adherence. Results. A total of 1253 patients initiated treatment; 95 were lost to follow-up, and 24 discontinued therapy. SVR rates were 95.1% (1079/1134) per protocol and 86.1% (1079/1253) intent to treat. The mean age (SD) was 57.4 (10.1) years, the mean body mass index (SD) was 28.7 (6.2) kg/m(2), 63.9% were male, 53.7% were black, 40.3% were cirrhotic, 88.4% were genotype 1, and 81.6% were treatment-naive. Patients missing >= 1 dose had an SVR of 74.9%; full adherence yielded 90% (P < .0001). Conclusions. HCV treatment by clinical pharmacists in an open medical system resulted in high SVR rates comparable to realworld studies with specialists and nonspecialists. These findings demonstrate the success of a clinical pharmacist-delivered method for HCV treatment expansion and elimination.en_US
dc.description.sponsorshipThis work was supported by an investigator-sponsored research grant from Gilead Sciences Inc. (IN-US-342-4530). The contents are solely the responsibility of the authors and do not necessarily represent the official views of Gilead.en_US
dc.publisherOpen Forum Infectious Diseasesen_US
dc.rightsThis article is available under the Creative Commons CC-BY-NC-ND license and permits non-commercial use of the work as published, without adaptation or alteration provided the work is fully attributed.
dc.subjecthepatitis C virusen_US
dc.subjectclinical pharmacistsen_US
dc.subjectHCV eliminationen_US
dc.subjectdirect-acting antiviralen_US
dc.titleExpanding Hepatitis C Virus Care and Cure: National Experience Using a Clinical Pharmacist-Driven Modelen_US

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