January 08, 2019
2 min read

Collaborations between rural clinics, pharmacists provide ‘excellent’ HCV outcomes

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Collaborative practice agreements between pharmacists and rural clinics that targeted American Indian/Alaska Native populations led to successful outcomes for patients with hepatitis C virus, according to findings recently published in the Journal of Primary Care and Community Health.

Rebecca Geiger, PharmD, MHA, BCACP, of the Indian Health Service in Lawton, Oklahoma, and colleagues gathered patient data from 11 health facilities that serve American Indian/Alaska Natives with HCV. According to researchers, many of these locations are rural and understaffed.

These clinics allowed a pharmacist — under a physician’s supervision — to place laboratory orders, choose medication regimens and therapy duration, manage medication procurement and adverse events, provide thorough medication counseling and identify prescription and over-the-counter drug interactions that could potentially increase treatment adherence and cure. In some instances, the pharmacist also connected patients with other HCV-related services.

Geiger and colleagues found that of the 1,789 patients with HCV-positive antibodies, 1,381 had a confirmation test. Of the 929 who tested positive in this second test, 576 had liver fibrosis scored and 335 had initiated treatment. In addition, all 274 patients who took a sustained virologic response/cure test received negative results.

“These data did not seek to track default or treatment failures, and likely overestimate true [sustained virologic response] rates as complicated patients may be referred to external specialists, although treatment outcomes are still thought to be excellent,” researchers wrote.

“These data indicate that rural clinics using collaborative practice agreements with pharmacists can be instrumental in HCV services at the primary care level and have strong outcomes in HCV treatment/sustained virologic response at 12 months,” they added.

Geiger and colleagues cautioned local barriers may hinder broad replication of their findings. They also suggested future research address obstacles that cause patients to be lost to follow-up, such as stigma, transportation, costs or efficacy of treatment. – by Janel Miller

Disclosures: The authors report no relevant financial disclosures.