A multidisciplinary support programme increases the efficiency of pegylated interferon alfa-2a and ribavirin in hepatitis C

Carrión, J.A.; González-Colominas, Elena; García–Retortillo, Montserrat; Cañete, Núria; Cirera, Isabel; Coll, Susanna; Giménez, M.D.; Márquez, Carmen; Martín-Escudero, Victoria; Castellví, Pere; Navinés, Ricard; Castaño, José María Huerta; Galeras, Josep Antón; Salas, E.; Bory, Felipe; Martín‐Santos, Rocío; Solá, Ricard

doi:10.1016/j.jhep.2013.06.019

Cited by 31 publications

(31 citation statements)

References 34 publications

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“…Furthermore, limited tolerance of side effects often caused patients to interrupt ongoing antiviral therapy [15]. This information might suggest that in tertiary Hepatology centres, global clinical support should be offered, as recently proposed in a Spanish randomized controlled trial [16].…”

Section: Discussionmentioning

confidence: 99%

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Prospective, observational real-life study on eligibility for and outcomes of antiviral treatment with peginterferon α plus ribavirin in chronic hepatitis C

Vukotic¹,

Gamal²,

Andreone³

2015

Digestive and Liver Disease

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Section: Discussionmentioning

confidence: 99%

“…A c c e p t e d M a n u s c r i p t 16 A c c e p t e d M a n u s c r i p t 23 Table 3. Epidemiological, laboratory and clinical data between treated and not-treated patients.…”

mentioning

confidence: 99%

Prospective, observational real-life study on eligibility for and outcomes of antiviral treatment with peginterferon α plus ribavirin in chronic hepatitis C

Vukotic¹,

Gamal²,

Andreone³

2015

Digestive and Liver Disease

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“…An earlier study in Interferon based AVT era also assessed the importance of MDT comprising two hepatologists, two nurses, one pharmacist, one psychologist, one administrative assistant, and one psychiatrist. They reported increased efficiency and compliance in MDT approach as compared to historic control group [25]. The management of HCV infections is centered on pharmacotherapy, making the clinical pharmacist appropriately suited as part of the patient's care team.…”

Section: Discussionmentioning

confidence: 99%

“…All these factors may lead to issues with adherence to very expensive DAA for recurrent HCV infection resulting into lesser efficacy. Multidisciplinary team approach has been studied and reported to be successful in the era of interferon based AVT for patients with HCV infection in a nontransplant setting [25]. Improvement in patient compliance and the efficiency of antiviral treatment has already been reported in the non-transplant setting.…”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary Approach to treat Liver Transplant Recipients with Hepatitis C using Sofosbuvir based Therapy

Pastrana-Camacho

Bradley

Winters

et al. 2017

GHOA

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Introduction: The safety and efficacy of the direct acting antivirals in liver transplant recipients is unknown. Materials and Methods:Retrospective cohort study on 44 liver transplant recipients, ≥18 years old who received Sofosbuvir (SOF) based antiviral therapy (AVT) at our hospital from January 2012 through May 2016. Multidisciplinary (MDT) approach involving hepatologists, transplant pharmacists and a patient access coordinator was adapted. SVR at 12 and 24 weeks, safety and compliance of SOF based AVT were reported. We also reported on improvement in APRI and CPT score at SVR.Results: 35 patients (79.5%) were treated with Ledipasvir (LDV) /SOF, 7 (16 %) with SOF/RBV and 2 (4.5%) with SOF/Simeprevir (SIM). Most patients were HCV genotype 1 (n=37; 84.1%) and treatment experienced (n= 24; 55%). Median time between liver transplant (LT) and AVT was 2.7 years with majority (66%) treated ≥ 12 months after LT. Median pre-treatment HCV viremia was 3,800,000 (71,000-66,000,000) with a high viral load ≥ 800,000 copies/ml in 36 (82%) patients. SVR 12 and 24 were achieved in 43/44 (98%), despite a low (77.3%) rapid virological response. Statistically significant improvement was observed in pre-treatment and post-SVR median albumin levels, APRI and CPT scores. Fatigue (27%) was the most commonly reported adverse effect. Compliance rate was 100%. Conclusion:With a MDT approach, using SOF based AVT, a very high SVR was achieved in liver transplant recipients with recurrent HCV infection. A MDT approach positively impacts medication acquisition, enhances patient education and compliance in post LT HCV management.

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“…Clinical pharmacists have played a critical role in the clinical management of individuals living with HIV and/or HCV 7–24. Some of the roles of clinical pharmacists have included reviewing patients’ medical records to identify appropriate ART and DAA medication regimens, acquisition of medications through prior authorizations (PAs), identifying potential DDIs, and monitoring laboratory tests to avoid AEs.…”

Section: Introductionmentioning

confidence: 99%

Role of a clinical pharmacist as part of a multidisciplinary care team in the treatment of HCV in patients living with HIV/HCV coinfection

Olea

Grochowski

Luetkemeyer

et al. 2018

IPRP

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BackgroundThe objective of the study was to evaluate the role of a clinical pharmacist in hepatitis C virus (HCV) treatment of patients living with HIV/HCV coinfection.MethodsWe conducted a descriptive study to quantify the functions of a clinical pharmacist in HCV treatment of patients living with HIV/HCV coinfection who were initiating HCV treatment at a publicly funded clinic between March 18, 2015 and September 15, 2016. The clinical pharmacist’s role was categorized into eight categories: 1) HCV prior authorization (PA) completion; 2) HCV medication adherence counseling; 3) HCV drug-drug interaction (DDI) counseling and screening; 4) HCV medication counseling regarding common adverse events (AEs); 5) HCV counseling regarding HCV treatment outcomes and risk of reinfection; 6) ordering laboratory tests and interpretation of HCV laboratory values; 7) HIV medication AE assessment; and 8) other (including refilling medications and management of other comorbidities).ResultsOne hundred and thirty-five patients initiated treatment during this timeframe: 77.0% were males, 56.3% non-cirrhotic, 77.0% HCV treatment-naïve, 45.9% HCV genotype 1a, and 83.0% initiated on ledipasvir/sofosbuvir. The clinical pharmacist completed 150 PAs, counseled on HCV medication adherence in 79.2% of patients, conducted HCV DDI counseling and screening in 54.2%, and monitored HCV medication AEs in 54.2%. The clinical pharmacist counseled patients on HCV treatment outcomes and risk of reinfection in 53.1%, ordered laboratory tests in 44.8%, and reported and interpreted laboratory values in 44.8%. The clinical pharmacist assessed HIV medication AEs in 54.2% of patients and participated in other activities in 42.7%.ConclusionA clinical pharmacist’s expertise as part of a multidisciplinary care team facilitates optimal treatment outcomes and provides critical support in the management of DAA therapy in individuals living with HIV/HCV coinfection.

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A multidisciplinary support programme increases the efficiency of pegylated interferon alfa-2a and ribavirin in hepatitis C

Cited by 31 publications

References 34 publications

Prospective, observational real-life study on eligibility for and outcomes of antiviral treatment with peginterferon α plus ribavirin in chronic hepatitis C

Prospective, observational real-life study on eligibility for and outcomes of antiviral treatment with peginterferon α plus ribavirin in chronic hepatitis C

Multidisciplinary Approach to treat Liver Transplant Recipients with Hepatitis C using Sofosbuvir based Therapy

Role of a clinical pharmacist as part of a multidisciplinary care team in the treatment of HCV in patients living with HIV/HCV coinfection

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