Retrospective Evaluation on Patient Screening and Counseling Service on Direct-acting Antivirals Against Hepatitis C

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.