Patient Education and Treatment Strategies Implemented at a Pharmacist-Managed Hepatitis C Virus Clinic

Bonnie Kolor, Pharm.D.

Disclosures

Pharmacotherapy. 2005;25(9):1230-1241. 

In This Article

Role of the Pharmacist in Managing Drug Therapy

In recent years, several reports have described the collaboration of clinical pharmacy specialists with physicians and other health care professionals in managing the drug therapy of patients with chronic disease.[20,21] For example, pharmacists have participated as members of multidisciplinary clinical teams in the treatment of patients with diabetes, hypertension, depression, heart disease, asthma, hyperlipidemia, anticoagulation needs, and HCV infection.[22,23,24,25,26,27,28,29] In some cases, patients are referred by physicians or physician extenders to pharmacist-managed specialty clinics.

Roles assumed by clinical pharmacy specialists at some of these clinics involve educating patients about their disease and its treatment, managing adverse effects of drug therapy, ordering and monitoring appropriate laboratory tests and data, and adjusting drug dosages when necessary.[30] Studies have shown that participation of clinical pharmacists in the drug therapy management of patients facilitated adherence to therapy, improved outcomes of drug therapy, and increased the cost-effectiveness of treatment.[23,27,31,32]

This article describes patient education and treatment strategies implemented by clinical pharmacists who are actively involved in managing patients with HCV infection at a pharmacist-managed clinic that is part of a multidisciplinary liver clinic in a managed care environment (VA medical center). These pharmacists have received additional clinical training specific to the needs of patients infected with HCV. The scope of practice of these pharmacists is based on VA treatment guidelines that enable the pharmacists to order laboratory tests, prescribe drug therapy, and make dosage adjustments in one or both components of the peginterferon alfa plus ribavirin therapy. A gastroenterologist is consulted for areas outside this scope of practice.

Treatment of patients infected with HCV is particularly suited to direct involvement of a clinical pharmacist due to the need for long-term drug therapy, frequent monitoring of patients and, often, dosage adjustments. Pharmacist-managed HCV clinics, such as the one described, are particularly useful in geographic areas associated with a high prevalence of HCV infection.

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