Implementation of hepatitis C screening within a pharmacist-managed medication-assisted therapy opioid use disorder protocol program

Introduction: New evidence suggests that emergency department (ED)-based infectious diseases screening programs have utility. We aimed to compare clinic-based and ED-based hepatitis C virus (HCV) screening programs within a single health system, to identify key differences in HCV antibody (Ab) positivity and chronic HCV, as well as population demographics. Methods: In the clinic-based program, adults in the birth cohort (born 1945-1965) were screened for HCV. In the ED-based program, non-targeted HCV screening of all adults was conducted. We included patients screened between June 2019–June 2020. Patients were screened for anti-HCV Ab, and positive results were followed by HCV viral load (VL) testing. Our primary outcomes were seroprevalence of HCV Ab and HCV VL. Results: There were 1,296 and 12,778 patients screened for HCV in the clinics and the ED, respectively. In the clinic setting, 13 patients (1%) screened positive for HCV Ab and nine (69%) completed VL testing, which was positive in one patient (11%). In the ED, 1,053 patients (8%) screened positive for HCV Ab and 847 (80%) underwent reflex VL testing, which was positive in 381 patients (45%). In an ED birth cohort sub-analysis, Hepatitis C virus Ab seroprevalence was 15% (675/4521). Conclusion: In this study of patients in a single healthcare system, ED-based HCV screening was higher yield than clinic-based screening.

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“…Pharmacist-driven public health initiatives have demonstrated success in myriad settings. [25][26][27][28][29][30][31]…”

Section: Discussionmentioning

confidence: 99%

Comparing Hepatitis C Virus Screening in Clinics Versus the Emergency Department

Hluhanich

Ford

Bruce

et al. 2022

WestJEM

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“…While the currently described roles are important activities and acute care pharmacists are well positioned to optimize the medication use process related to OUD interventions, the literature describing outpatient pharmacist activities abounds with examples that should also be explored in the acute care setting. Examples include pharmacist-led programs to improve commonly co-occurring infectious disease screening 29,30 and complex medication management. 31 The pharmacist-led pain consult team 24 provides a unique example that could be expanded into other domains, including pharmacist-led psychiatric and infectious diseases consult services.…”

Section: Discussionmentioning

confidence: 99%

Role of the pharmacist in acute care interventions for opioid use disorder: A scoping review

Irwin

Walkerly

2021

J Am Coll Clin Pharm

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Opioid use disorder (OUD) is associated with significant morbidity and mortality in the United States. In recent years, interest in initiatives to increase access to medication for OUD (MOUD) and overdose-reversing medications (naloxone) in acute care has grown. While well positioned to intervene, the role of acute care pharmacists in these interventions is not known. The objective for this scoping review was to better understand what is presently known about the role of pharmacists in acute care OUD interventions. These were defined as initiatives implemented in either inpatient or emergency department (ED) settings aimed at treatment of OUD (eg, initiation or management of MOUD) or harm reduction in individuals with OUD (eg, education or targeted naloxone dispensing). PubMed/MEDLINE and Embase databases were searched for articles pertaining to the research question from inception to 19 May 2021. Pearling was performed after the identification of eligible articles. Articles had to explicitly describe the pharmacist's role in planning, implementing, or evaluating an OUD intervention in the inpatient or ED setting.Data charting was performed by both authors using a predefined template, and data synthesis was performed via discussion between authors. The initial title search yielded 101 references which were screened and resulted in four articles that met inclusion criteria. Three additional articles were identified in the pearling process, yielding a total of seven articles. Four described initiatives aimed at point-ofcare dispensing of naloxone, and three described initiatives for provision or management of MOUD. Pharmacist roles primarily consisted of medication use process management, hospital staff and patient education, and dispensing activities. Literature describing the role of pharmacists in acute care OUD interventions is limited.Given the burden of OUD, there are many opportunities for further exploration of the roles acute care pharmacists can play in OUD harm reduction and treatment.

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Innovating the Model for Student Pharmacists to Increase Access to Hepatitis C Testing (Project IMPACT)

Januszka¹,

Notarianni²,

Devenny³

et al. 2023

Journal of the American Pharmacists Association

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Implementation of hepatitis C screening within a pharmacist-managed medication-assisted therapy opioid use disorder protocol program

Cited by 3 publications

References 15 publications

Comparing Hepatitis C Virus Screening in Clinics Versus the Emergency Department

Comparing Hepatitis C Virus Screening in Clinics Versus the Emergency Department

Role of the pharmacist in acute care interventions for opioid use disorder: A scoping review

Innovating the Model for Student Pharmacists to Increase Access to Hepatitis C Testing (Project IMPACT)

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