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JASON P. SMITH, PHARM.D., is Clinical Pharmacy Specialist, Greater Los Angeles Veterans Affairs Healthcare System (GLAVAHS), Los Angeles, CA. MAMIE H. DONG, M.D., is Internal Medicine Resident, School of Medicine, University of California Los Angeles. JONATHAN D. KAUNITZ, M.D., is Associate Chief of Hepatology, GLAVAHS.

Address correspondence to Dr. Smith at the Department of Pharmacy, Greater Los Angeles Veterans Affairs (VA) Healthcare System, Building 500, Suite 4046a, West Los Angeles VA Medical Center, 11301 Wilshire Boulevard, Los Angeles, CA 90073 (jason.smith2{at}va.gov).

Purpose. A description of an effort to create a more time, labor, and cost-efficient method for the management of patients with hepatitis C virus (HCV) infection in Department of Veterans Affairs (VA) hospitals is provided; this pilot study also revealed the outcomes of a pharmacist-managed clinic for these patients in comparison to established standards of care. Methods. A retrospective analysis was performed on data obtained from patients who were referred to the clinic between October 2002 and March 2004 and who had a clinical pharmacist as their primary treatment provider. The patients’ medical records were searched for demographic information, disease characteristics, treatment information, treatment and safety information, and virological response. Results. Thirty-one patients were evaluated, and 27 were offered antiviral therapy in the hepatitis C care clinic between October 2002 and March 2004. Of the 27 patients who had sufficient data for analysis, there was a sustained response rate of 63% (17 of 27) overall after treatment with peginterferon and ribavirin combination therapy. Only 3 patients (11%) stopped therapy early secondary to adverse effects, whereas 8 (30%) were managed with growth factors. Conclusion. VA patients managed by a clinical pharmacist for the treatment of chronic HCV infection demonstrated similar treatment outcomes compared with the results from earlier studies with VA patients managed with traditional care. Further studies are warranted to investigate the role of the pharmacist in the management of patients with HCV infection. Index terms: Ambulatory care; Antivirals; Clinical pharmacists; Combined therapy; Economics; Hematopoietic agents; Hepatitis C; Peginterferon alfa 2-a; Peginterferon alfa 2-b; Ribavirin; Toxicity

 

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