ABSTRACT
Background:
People who inject drugs (PWID) are a key
population for
treatment with direct-acting
antiviral medications (DAAs) to eliminate
hepatitis C virus (HCV). We developed a
Pharmacist,
Physician, and
Patient Navigator Collaborative Care Model (PPP-CCM) for delivery of HCV
treatment; this study describes clinical outcomes related to HCV
treatment (initial evaluation,
treatment initiation, completion, and
cure), as well as
patient satisfaction.
Methods:
We conducted a single-
arm prospective
pilot study of
adult PWID living with HCV. Participants completed baseline and six-month follow-up surveys, and
treatment and outcomes were abstracted from
electronic health records. Primary outcome was linkage to
pharmacist for HCV evaluation;
secondary outcomes included DAA initiation, completion, and
cure, as well as
patient-reported
satisfaction.
Results:
Of the 40 PWID enrolled, mean age was 43.6 years, 12 (30 %) were
female, 20 (50 %) were non-
white, and 15 (38 %) were unhoused. Thirty-eight (95 %) were successfully linked to the
pharmacist for initial evaluation. Of those, 21/38 (55 %) initiated DAAs, and 16/21 (76 %) completed
treatment. Among those completing
treatment who had
viral load data to
document whether they achieved "
sustained virologic response", i.e.
cure, 10/11 (91 %) were found to be cured. There was high
satisfaction with 100 % responding "agree or strongly agree" that they had a positive experience with the
pharmacist.
Conclusion:
Nearly all participants in this
pilot were successfully linked to the
pharmacist for evaluation, and more than half were started on DAAs; results provide preliminary evidence of feasibility of
pharmacist-led models of HCV
treatment for PWID. Clinicaltrialsgov registration number NCT04698629.
