Coupling patient care management operations with technology and data platform to optimize hepatitis C therapy outcomes

Abstract Background: Over the past 20 years there have been major improvements in the treatment and outcomes of hepatitis C pharmacotherapy. While the HCV treatment regimen is much simpler, safer, and more effective, there is an opportunity to improve the overall patient journey. Aims: The objective of this observational study is to demonstrate the cure rate measurement possible with standardized pharmacy clinical operations supported by a technology platform. Methods: The study period covered January 1 to September 30, 2018. In the patient care process, the pharmacist collaborates with the clinic staff to select the best treatment regimen based on clinical guidelines. The pharmacist also selects the treatment regimen to satisfy coverage policy. In this way, patient onboarding is streamlined and therapy initiation is expedited. Patient evaluation is performed in the clinic, and initial patient education is provided and documented. The data necessary for outcomes measures such as genotype, viral load, and past medical history is documented during the care process. The monthly monitoring plan is established for adherence and side-effect management. The entire care process is facilitated by a technology platform where documentation is completed. Results: In the study cohort, 209 patients were onboarded to the technology platform through the clinic process. Of the 209 patients, 183 were provided an initial clinical assessment. The appropriate end points for this study were: documentation of therapy completion using dispensing and adherence data, lab data at the end of treatment, and SVR12 value. A total of 150 patients had all three of the end point measures documented. Of the 28 patients who did not have the end points documented, seven had a discontinuation survey completed and 21 were lost to follow-up for unknown reasons. In this study cohort, 99% of patients completed therapy and had SVR12 confirmed by lab data, yielding a cure rate of 98%. Conclusions: In this observational study of standardized clinical pharmacy operations provided in a medical clinic supported by a pharmacy technology platform it was demonstrated that the pharmacy care process can be streamlined between the numerous steps and become a dynamic patient management operation. In addition, the study demonstrated that an intuitive and robust data platform can greatly improve longitudinal follow-up and HCV cure rate measurement.