Therapeutic monitoring and pharmacist intervention in a Hansen's disease clinic.
OBJECTIVE
To describe the role of the clinical pharmacist in a Hansen's disease (HD, leprosy) clinic and to describe the development, validation, and operation of a dapsone compliance monitoring program.


BACKGROUND
HD remains a major, worldwide healthcare problem. Dapsone is the drug of choice for treatment of HD; however, high rates of noncompliance with this agent have been reported by many treatment centers. The assessment of compliance in HD patients is important to help distinguish between treatment failure secondary to noncompliance or to the development of resistance.


METHODS
In the US, the Chicago Regional Hansen's Disease Center at the University of Illinois at Chicago is one of ten centers that provide comprehensive care to patients diagnosed with this condition. This article reviews the clinical pharmacy services and dapsone compliance program in the clinic encompassing the years 1983-93.


RESULTS
The clinical pharmacist provides a variety of clinical services in the clinic as well as coordinating the clinical research program. A pharmacist-generated dapsone compliance program led to improvement in compliance rates and clinical outcome. This improvement in compliance has been sustained over an extended period of time.


CONCLUSIONS
The clinical pharmacy services performed in the HD clinic provide a model for pharmacy involvement in other chronic disease states. The dapsone compliance program has been successful in improving patient care and obtaining reimbursement for clinical pharmacy services.
Piscitelli
S C
SC
Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago 60612.
Occhipinti
D J
DJ
Danziger
L H
LH
Hill
C
C
West
D P
DP
Fischer
J H
JH
D000046:Academic Medical Centers; D002641:Chicago; D002991:Clofazimine / Q000627:therapeutic use; D003622:Dapsone / Q000627:therapeutic use*; D016903:Drug Monitoring; D006801:Humans; D007918:Leprosy / Q000188:drug therapy*; D010348:Patient Care Team; D010349:Patient Compliance; D010607:Pharmacy Service, Hospital; D012293:Rifampin / Q000627:therapeutic use
D003622:Dapsone; D002991:Clofazimine; D012293:Rifampin