Background

Patients with chronic hepatitis C (HCV) infection who belong to priority populations (homelessness or unstable housing, +/- injection drug use, +/- interaction with Corrections system, +/- Indigenous, +/- rural) experience inequities in access to HCV testing and treatment across Alberta, Canada due to location or stigma.

Objective

To evaluate the effect of a community pharmacy-based case finding and intervention program on cure rates in patients living with HCV.

Methods

Study design: Multi-centre, before-after study

Setting: Up to 100 pharmacies across Alberta

Population: Patients aged >18 y/o with positive HCV infection belonging to priority populations

Intervention: Pharmacists will complete HCV antibody testing using point-of-care and confirmatory testing with dried blood spots. For individuals with confirmed HCV, pharmacists will prescribe HCV treatment, follow up regularly, monitor, and assess for HCV cure.

Outcomes

Primary: Evaluate the effect of a community pharmacy-based case finding and intervention program on cure rates in patients living with Hepatitis C, assessed using a negative HCV PCR 12 weeks, a sustained virologic response (SVR), after completing 8 to 12 weeks of DAA therapy. Secondary: Patient-reported quality of life and satisfaction with pharmacist-led Hepatitis C care

Current status: In enrollment and site initiation phase; 11 pharmacies and 26 pharmacists have completed site onboarding.

Discussion

To our knowledge this is the first large trial evaluating the impact of community pharmacists case finding, independent prescribing and ordering lab tests on cure rates in patients living with HCV