Campos Fernández de Sevilla María Ángeles, Gallego Úbeda Marta, Heredia Benito Miriam, García-Cabrera Emilio, Monje García Beatriz, Tovar Pozo María, Delgado Téllez de Cepeda Laura, Iglesias-Peinado Irene
Pharmacy Department, Hospital Universitario del Henares, Coslada, Madrid, Spain.
Delos Clinical, Sevilla, Spain.
Int J Clin Pharm. 2019 Apr;41(2):488-495. doi: 10.1007/s11096-019-00809-3. Epub 2019 Apr 27.
Background A pharmaceutical care program is necessary to improve the management of direct-acting antivirals in hepatitis C. Objective Describe health outcomes obtained with the implementation of a pharmaceutical care program in Hepatitis C patients treated with direct-acting antivirals. Setting This study was performed in a pharmacy department of a university hospital. Methods Retrospective study between 1st-April 2015 and 28st-February 2016. Hospital pharmacists implemented interventional measures for validation of antivirals prescriptions, detection of drug-interaction, adverse drug events, education and patient´s adherence to antiviral regimen. Main outcome measure Health and quality outcomes of the implementation of the pharmaceutical care program. Results A total 128 patients were enrolled. The overall sustained virologic response at week 12 post-treatment rate was 96.1% (95% CI 92.7-99.5). Adverse drug events occurred in 90.6% of the patients, and the majority were grade 1-2. Pharmacists made 334 pharmaceutical interventions. 35.5% of these interventions were aimed to resolve negative results of drugs. 80.9% of the negative results of drugs improved or were eliminated with the application of the measures proposed by the pharmacists (p ≤ 0.001). Pharmacists carried out 175 preventive interventions to avoid negative results of drugs. 97.3% of these interventions were accepted and managed to prevent the appearance of negative results of drugs (p = 0.453). Conclusion The implementation of a pharmaceutical care program in patients with hepatitis C treated with direct-acting antivirals has improved the safety in the use of these drugs.
背景 实施药物治疗管理计划对于改善丙型肝炎直接抗病毒药物的管理很有必要。目的 描述在接受直接抗病毒药物治疗的丙型肝炎患者中实施药物治疗管理计划所取得的健康结果。地点 本研究在一家大学医院的药房进行。方法 回顾性研究，时间跨度为2015年4月1日至2016年2月28日。医院药剂师实施了干预措施，以验证抗病毒药物处方、检测药物相互作用、药物不良事件、开展教育并提高患者对抗病毒治疗方案的依从性。主要结局指标 药物治疗管理计划实施后的健康和质量结果。结果 共纳入128例患者。治疗后第12周的总体持续病毒学应答率为96.1%（95%置信区间92.7 - 99.5）。90.6%的患者发生了药物不良事件，且大多数为1 - 2级。药剂师进行了334次药学干预。其中35.5%的干预旨在解决药物的负面结果。通过应用药剂师提出的措施，80.9%的药物负面结果得到改善或消除（p≤0.001）。药剂师开展了175次预防性干预以避免药物出现负面结果。其中97.3%的干预被接受，并成功预防了药物负面结果的出现（p = 0.453）。结论 在接受直接抗病毒药物治疗的丙型肝炎患者中实施药物治疗管理计划提高了这些药物使用的安全性。
