Outcomes of a Pharmacist-led Care Delivery Model for Patients on Methadone Maintenance Therapy With Chronic Hepatitis C

Author: Sara Ditursi Gurjot Sandhu

Theme: Models of Care Year: 2022

Catholic Health is a comprehensive healthcare system in western New York and offers outpatient
medication-assisted treatment for substance-use disorders to approximately 1,200 patients. A
pharmacist-led chronic hepatitis C (HCV) clinic was established at two methadone maintenance
therapy clinics to overcome barriers to accessing HCV care in a high-risk population.
Description of model of care/intervention:
The clinical pharmacist was responsible for HCV care under a Collaborative Drug Therapy
Management protocol. Referrals were obtained through the substance-use disorder providers. This
innovative treatment model integrated infectious diseases care into addiction services, and included
patients who were actively using intravenous drugs.
One hundred thirty-eight patients were referred to the HCV clinic during the study period. A total of
30 patients achieved sustained viral response at 12 weeks (SVR12), with 46 patients awaiting initial
or SVR12 labs. Forty-eight were discharged from the program prior to initiating therapy, were not
ready to initiate treatment, self-discontinued therapy or completed therapy and were lost to followup prior to attainment of SVR12 labs. The pharmacist addressed a total of 20 adverse drug effects,
16 adherence concerns, 15 drug-drug interactions, and counseled a total of 67 patients.
Conclusion and next steps:
The establishment of this program demonstrates the utility of clinical pharmacists in optimizing HCV
care in a substance-use disorder population. The clinical pharmacist served an integral role in
screening, assessing readiness for treatment, medication selection, prior authorization, identification
and management of drug-drug interactions and continued assessment of medication adherence.
Barriers in this clinic included ability to obtain labs on-site and inability to follow patients who were
discharged from the clinic prior to initiating therapy.
Disclosure of Interest Statement:
The authors of this abstract have no conflicts of interest to disclose. This study was unfunded. This
research was approved by the Catholic Health System Internal Review Board.

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