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In Hong Kong, arthritis is the third leading chronic disorder among the older people. It could create a huge amount of burden on the health care system if patients cannot achieve good diseases control and have recurrent flare up of diseases. To maintain stable control and minimize acute flare up, medication adherence is essential. Studies revealed that drug education has the highest evidence in improving medication adherence. Pharmacists who are expert in drugs can provide counseling to arthritis patients, improving their drug adherence and disease activities. As a result, research evaluating the effectiveness of pharmacist counseling service on improving arthritis patients’ medication adherence and disease activities in Hong Kong has been initiated in a specialist out-patient clinic of a local acute hospital. This research aims to improve patient medication adherence and enhance medication safety. A validated Compliance Questionnaire on Rheumatology (CQR-19) is used to measure the medication adherence. From the preliminary data, over 90% of the recruited subjects are non-adherence at baseline and thus, detailed drug counseling is necessary. During the first visit, pharmacists will provide a 20 minutes drug counseling service to the referred patients. This includes discussion on drug administration schedule, importance of drug adherence, side effects management and pain management. Besides, pharmacists also have different roles in other aspects such as drug information and procurement. Pharmacists would assist in providing evidence-based information and recommendations to physicians and nurses for drug-related enquiries. These attempts to improve therapeutic outcomes and minimize medication errors, enhance medication safety and reduce hospitalization. Design of the multidisciplinary care model and results of this study would provide a reference for the future development of clinical pharmacist service in rheumatology.

Objective: Drug-drug interactions and risk of hepatitis B reactivation potentially affect treatment outcomes of direct-acting antivirals (DAA) against hepatitis C. A comprehensive pharmacist screening and counseling service was implemented in a Hong Kong hospital, which aims to optimize the efficacy and safety of DAA therapy while minimizing the risk of drug wastage. The objective of the service review is to explore potential roles of pharmacist in hepatitis C management. Design: We retrospectively evaluate all cases under service from June 2017 to September 2018. Main outcome measures: Outcomes measured include drug-related problems (DRP) identified, treatment discontinuation and failure rates. Results: There were 44 cases under provision of service, all completed therapy except 1 died from underlying disease. 25 DRPs, predominantly categorized as drug-drug interactions, were documented. The interactions commonly involved acid-lowering agents. 1 case was noted with inadvertently lengthening of treatment duration. No cases of treatment failure or hepatitis B reactivation were reported. Conclusion: The safety concerns and high cost of DAA have created a new challenge to healthcare providers. Comprehensive screening and counseling by pharmacists are valuable to ensure safe and effective use of DAA, hence reducing unnecessary drug wastage.