Authors (including presenting author) :
Wong KH(1), Chong CH(1)
Affiliation :
(1)Department of Pharmacy, United Christian Hospital
Introduction :
The recent introduction of direct-acting antivirals (DAA) has provided more effective yet costly alternatives for chronic hepatitis C treatment. However, drug-drug interactions and risk of hepatitis B reactivation potentially affect treatment outcomes. A comprehensive pharmacist screening and counseling service was implemented in United Christian Hospital, which aims to optimize the efficacy and safety of the therapy while minimize the risk of drug wastage due to unintended prescribing beyond the standard duration.
Objectives :
- To review the service for pharmacist screening and counseling targeting patients prescribed with DAA against hepatitis C
- To evaluate the utilization of DAA therapy in local population
Methodology :
For cases initiated with DAA, pharmacists would review on the drug dosage, duration, hepatitis B status and medication profile. Patient counseling was provided with medication supplied as refills every 4-6 weeks. We retrospectively evaluate all cases under provision of care since service initiation from June 2017 to September 2018. Outcomes measured include drug related problems (DRP) identified, treatment discontinuation and failure rate.
Result & Outcome :
There were 44 cases under provision of service. All cases completed DAA therapy, except 1 died from advanced cirrhosis. 3 cases have positive hepatitis B serology, with preemptive treatment and/or blood monitoring given. No cases of hepatitis B reactivation or treatment failure is reported. 25 DRPs were documented. Drug-drug interactions (84%) was commonly involved, in which acid-lowering agents are readily available over-the-counter. 1 case was noted with documented duration longer than standard regimen. Co-morbidities are common, and the associated admissions and follow-ups from other specialties possess a risk on unrecognized drug-drug interactions. The safety concerns and high cost of DAA have created a new challenge to healthcare providers. Comprehensive screening and counseling are valuable to ensure safe and effective use of DAA in hepatitis C patients, hence reduce unnecessary drug wastage.
Co-location with:
