title: Evaluation of a Hepatitis C Patient Management Program at a University Specialty Pharmacy.
abstract: BACKGROUND
  The University of Rochester (UR) Specialty Pharmacy hepatitis C patient management program offers a unique advantage of being integrated within the same health system as the University of Rochester Medical Center (URMC) Gastroenterology and Hepatology division.
  
  
  OBJECTIVE
  The primary purpose of this study was to assess treatment success through the incidence of achieving a sustained virological response (SVR) in patients served by the UR Specialty Pharmacy versus other nonintegrated pharmacies.
  
  
  METHODS
  This was a single-center retrospective cohort study in adult patients of URMC Gastroenterology and Hepatology prescribed hepatitis C treatment between January 1, 2014, and July 15, 2015. The incidence of SVR, adherence, delay in therapy initiation, early treatment discontinuation, rate of attainment of viral load measurement post-therapy completion, and predictors associated with treatment outcome were assessed.
  
  
  RESULTS
  A total of 414 patients were prescribed hepatitis C virus treatment during the study period; 137 did not initiate therapy. The rate of SVR was 93% among patients at the UR Specialty Pharmacy and 89% at nonintegrated pharmacies ( P = 0.357). Adherence to therapy was 100% and 97% at the UR Specialty Pharmacy and nonintegrated pharmacies, respectively ( P = 0.046).
  
  
  CONCLUSIONS
  The UR Specialty Pharmacy was associated with a 93% SVR rate and significantly greater adherence compared with nonintegrated pharmacies. Larger studies are needed to determine if a significant difference in SVR exists between integrated and nonintegrated pharmacies. This study provides a framework for other institutions to justify developing integrated hepatitis C specialty pharmacy services and evaluate their success.
authors.affiliation: 1 University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Zaepfel
authors.affiliation: 1 University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Cristofaro
authors.affiliation: 1 University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Allison
authors.initials: A
authors.lastname: Trawinski
authors.affiliation: 1 University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Katharine
authors.initials: K
authors.lastname: McCarthy
authors.affiliation: 1 University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rightmier
authors.affiliation: 1 University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Tina
authors.initials: T
authors.lastname: Khadem
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D016174:Hepacivirus / Q000187:drug effects*; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D008297:Male; D054539:Medication Therapy Management / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D008875:Middle Aged; D010607:Pharmacy Service, Hospital / Q000379:methods / Q000458:organization & administration* / Q000592:standards; D015397:Program Evaluation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014495:Universities; D016903:Drug Monitoring
keywords: adherence; hepatitis C; integrated care; patient management program; predictors of treatment outcome; specialty pharmacy; sustained virological response