Article Text
Abstract
Background Triple therapy (telaprevir/pegylated interferon/ribavirin), is the treatment of choice in patients with genotype 1 chronic hepatitis C virus (HCV). Triple therapy (TT) requires active participation by the hospital pharmacist, because adverse effects and drugs interactions are important.
Purpose To assess the profile of patients who start treatment with TT and to describe the activities included within the pharmaceutical care.
Materials and methods Observational study of the demographic and clinical characteristics of patients who started treatment for HCV with TT through pharmacotherapeutic history of the pharmacy department in a 211-bed hospital. The concomitant treatment was evaluated and pharmaceutical care interventions recorded.
Results The Gastroenterology Service requested treatment with TT for 14 patients. Two of them were denied it because the degree of liver damage was lower than that established by the hospital protocol. Of the 12 requests approved, seven were for women. The mean age of patients was 42. Non-responders to previous treatment (5/12) and patients with cirrhosis (4/12) were typical patients. Haemoglobin, platelet and neutrophil counts were normal at the start of TT in all patients except one, with platelet counts below normal values. The review of the pharmacotherapeutic history allowed us to detect a drug contraindication between telaprevir and triazolam in one patient, three other patients showed a major drug-drug interaction between telaprevir and inhaled budesonide, and one had an interaction between telaprevir and domperidone; these were reported. In all cases, the gastroenterologist accepted the pharmaceutical intervention and he suspended drugs or reduced their dose. The pharmacist queried the viral load for two patients and referred a patient to the emergency room because of treatment side effects.
Conclusions The clinical characteristics of the patients who start TT, the drug interactions that were found and compliance with the protocol of our hospital, justify the Pharmaceutical Care of patients with chronic hepatitis C virus.
No conflict of interest.