Background The outpatient pharmacy unit (OPU), in consensus with the digestive service (DIG), held an intervention on selected chronic hepatitis B virus (HBV) infected outpatients. It consisted of decreasing the frequency of oral treatment from a monthly to a bimonthly basis. The aim was to reduce patient visits to the hospital and to diminish the healthcare burden in order to use human resources to improve pharmaceutical care.
Purpose To evaluate the impact on adherence and viral load (VL) after dispensing treatment on a bimonthly basis instead of a monthly basis to selected HBV outpatients.
Material and methods In May 2014, patients were transversely selected by OPU following the criteria reached by consensus with DIG: age >18 years, receiving any oral drug (alone or combined) for HBV infection, HBV VL ≤100 copies/mL in their last analysis, on stable treatment for at least 6 months previous to the study and related adherence throughout that period >80%. All selected patients were informed about the importance of adherence, and bimonthly dispensation was offered to them. The next set of data was collected from the medical records: sex, age and VL. Adherence was measured by indirect methods from the dispensation programme registry (Farmatools). In May 2015, adherence since the intervention and VL values were revised for the selected patients to evaluate the effect of the intervention.
Results 94 patients met the criteria but only 73 wanted to change to bimonthly dispensation: 56.15% male, median (P50) age 52 (44–61). Results refer to 63 patients, as 8 patients had no analysis after the intervention and 2 were lost to follow-up. After the intervention, 6 patients still met the criteria. 35 patients maintained the same VL and 17 had decreased VL (13 to undetectable). 9 had increased VL but still met the criteria and 8 of them had adherence variation <10%. Causes of not meeting the criteria: 1 patient for changing treatment (simplification) and 1 patient for diminished adherence from 88.24% to 57.13%. This patient returned to monthly dispensation.
Conclusion Bimonthly dispensation is a safe tool for maintaining stable adherence and VL in selected patients and could be used to rationalise the use of the limited human resources of pharmacy services and reduce patient visits to hospital.
References and/or Acknowledgements Ibarra O. Adherencia al tratamiento VHB. Grupo Hepatopatías Víricas. SEFH.2 junio 2010. Barcelona
No conflict of interest.
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