Assessing the proportion of patients with hepatitis C treated before and after initiation of an ambulatory pharmacist-led hepatitis C program: A retrospective analysis

Abstract

BackgroundIn a community with rates of hepatitis C virus (HCV) 10 times greater than the national average, a pharmacist-led HCV clinic creates a unique opportunity to make an extensive impact on a large population. This study aimed to describe the impact of an ambulatory pharmacist-led HCV clinic on successful HCV treatment initiation. ObjectivesThe primary objective was to determine HCV treatment initiation before and after introduction of a pharmacist-led HCV clinic. Secondary objectives include identifying benefits of the clinic through barriers that exist pre-and postclinic, average time to HCV treatment initiation, and current and last known points of care in the treatment process. Practice descriptionThe ambulatory program was established in 2018 with a collaborative practice agreement with gastroenterologists in the health system, allowing for providers to refer patients to the pharmacy clinic for HCV medication initiation and monitoring. Practice innovationThrough maintaining relations with providers, the local health department, and emergency department staff, pharmacists aimed to connect more patients to HCV treatment. Clinical pharmacists work with patients to refer them to specialty pharmacies, ensuring quick treatment start and financial coverage. Evaluation methodsA single-center, retrospective chart review was conducted to assess treatment initiation in patients with a positive HCV antibody in 2016 (preclinic) or 2019 (postclinic). ResultsA statistically significant difference was found for the proportion of patients that started treatment before versus after clinic initiation (P < 0.001). For secondary objectives, a statistically significant difference was found between the number of patients who completed the treatment process in 2016 and those in 2019 (P < 0.001). The average time from diagnosis to treatment initiation was reduced from 66.75 weeks ± SD 13.22 in 2016 to 22.87 weeks ± SD 4.19 in 2019. ConclusionAn ambulatory pharmacist-led HCV clinic results in a higher proportion of patients starting treatment for hepatitis C, better linkage to care, and shorter treatment duration.