Evaluation of a pharmacist-managed hepatitis C care clinic.
OBJECTIVE
A description of an effort to create a more time, labor, and cost-efficient method for the management of patients with hepatitis C virus (HCV) infection in Department of Veterans Affairs (VA) hospitals is provided; this pilot study also revealed the outcomes of a pharmacist-managed clinic for these patients in comparison to established standards of care.


METHODS
A retrospective analysis was performed on data obtained from patients who were referred to the clinic between October 2002 and March 2004 and who had a clinical pharmacist as their primary treatment provider. The patients' medical records were searched for demographic information, disease characteristics, treatment information, treatment and safety information, and virological response.


RESULTS
Thirty-one patients were evaluated, and 27 were offered antiviral therapy in the hepatitis C care clinic between October 2002 and March 2004. Of the 27 patients who had sufficient data for analysis, there was a sustained response rate of 63% (17 of 27) overall after treatment with peginterferon and ribavirin combination therapy. Only 3 patients (11%) stopped therapy early secondary to adverse effects, whereas 8 (30%) were managed with growth factors.


CONCLUSIONS
VA patients managed by a clinical pharmacist for the treatment of chronic HCV infection demonstrated similar treatment outcomes compared with the results from earlier studies with VA patients managed with traditional care. Further studies are warranted to investigate the role of the pharmacist in the management of patients with HCV infection.
Smith
Jason P
JP
Department of Pharmacy, Greater Los Angeles Veterans Affairs Healthcare System, West Los Angeles VA Medical Center, Los Angeles, CA 90073, USA. jason.smith2@va.gov
Dong
Mamie H
MH
Kaunitz
Jonathan D
JD
D000328:Adult; D000554:Ambulatory Care Facilities; D019468:Disease Management; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006787:Hospitals, Veterans; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010593:Pharmaceutical Services; D010595:Pharmacists; D011092:Polyethylene Glycols / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D024382:Professional Role; D011787:Quality of Health Care; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D016896:Treatment Outcome; D014481:United States; D014493:United States Department of Veterans Affairs
D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a