Zaepfel Michelle, Cristofaro Lisa, Trawinski Allison, McCarthy Katharine, Rightmier Elizabeth, Khadem Tina
1 University of Rochester Medical Center, Rochester, NY, USA.
Ann Pharmacother. 2017 Apr;51(4):307-314. doi: 10.1177/1060028016683495. Epub 2016 Dec 16.
The University of Rochester (UR) Specialty Pharmacy hepatitis C patient management program offers a unique advantage of being integrated within the same health system as the University of Rochester Medical Center (URMC) Gastroenterology and Hepatology division.
The primary purpose of this study was to assess treatment success through the incidence of achieving a sustained virological response (SVR) in patients served by the UR Specialty Pharmacy versus other nonintegrated pharmacies.
This was a single-center retrospective cohort study in adult patients of URMC Gastroenterology and Hepatology prescribed hepatitis C treatment between January 1, 2014, and July 15, 2015. The incidence of SVR, adherence, delay in therapy initiation, early treatment discontinuation, rate of attainment of viral load measurement post-therapy completion, and predictors associated with treatment outcome were assessed.
A total of 414 patients were prescribed hepatitis C virus treatment during the study period; 137 did not initiate therapy. The rate of SVR was 93% among patients at the UR Specialty Pharmacy and 89% at nonintegrated pharmacies ( P = 0.357). Adherence to therapy was 100% and 97% at the UR Specialty Pharmacy and nonintegrated pharmacies, respectively ( P = 0.046).
The UR Specialty Pharmacy was associated with a 93% SVR rate and significantly greater adherence compared with nonintegrated pharmacies. Larger studies are needed to determine if a significant difference in SVR exists between integrated and nonintegrated pharmacies. This study provides a framework for other institutions to justify developing integrated hepatitis C specialty pharmacy services and evaluate their success.
罗切斯特大学（UR）专科药房丙型肝炎患者管理项目具有独特优势，它与罗切斯特大学医学中心（URMC）胃肠病学和肝病科同属一个医疗系统。
本研究的主要目的是通过比较UR专科药房服务的患者与其他非一体化药房服务的患者实现持续病毒学应答（SVR）的发生率，来评估治疗效果。
这是一项单中心回顾性队列研究，研究对象为2014年1月1日至2015年7月15日期间在URMC胃肠病学和肝病科接受丙型肝炎治疗的成年患者。评估了SVR的发生率、依从性、治疗开始延迟、早期治疗中断、治疗完成后病毒载量测量的达标率以及与治疗结果相关的预测因素。
研究期间共有414例患者接受了丙型肝炎病毒治疗；137例未开始治疗。UR专科药房患者的SVR率为93%，非一体化药房患者的SVR率为89%（P = 0.357）。UR专科药房和非一体化药房的治疗依从性分别为100%和97%（P = 0.046）。
与非一体化药房相比，UR专科药房的SVR率为93%，且依从性显著更高。需要开展更大规模的研究来确定一体化药房和非一体化药房在SVR方面是否存在显著差异。本研究为其他机构开展一体化丙型肝炎专科药房服务并评估其成效提供了一个框架。
