Webinar: The Pharmacist’s Role in Closing Infectious Disease Care Gaps
Clearway Health recently hosted a webinar on ‘The Pharmacist’s Role in Closing Infectious Disease Care Gaps’ that focused on helping hospitals and health systems reduce new infections and treat more patients for disease states such as hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Panelists on the webinar included Mercedez Bernard, DO, family medicine, Comanche County Memorial Hospital in Lawton, Oklahoma; Richard McCormack, DPh, clinical pharmacist, Clearway Health working at Comanche County Memorial Hospital; Brenda Shih, PharmD, BCACP, clinical pharmacist, Clearway Health working at NeighborHealth located in Boston; and Rachel Arnold, PharmD, clinical pharmacist, Clearway Health working at The Brooklyn Hospital Center in Brooklyn, NY. Donisha Lewis, PharmD, BCACP, clinical program coordinator for Clearway Health, served as moderator of the webinar.
HCV Target Goals and Barriers
The World Health Organization’s 2030 HCV elimination target goals are to reduce new HCV infections by 90%, diagnose 90% of the HCV infected population, reduce HCV deaths by 65% and treat 80% of eligible patients. While the goal of reducing HCV deaths by 2030 is currently on track, more progress is needed to lower new infections. Dr. Bernard explained that the discrepancy is rooted in a combination of medical breakthroughs and public health hurdles such as the pandemic that have hindered progress.
“Overall, we have highly effective treatments, and we can cure HCV to over 95%, which is fantastic and is leading to fewer people progressing to the end state of liver disease and death,” said Bernard. “The mixed outcomes reflected are twofold; we've had a lot of medical triumphs and treatment mortality reduction, but we also have persistent social, structural and behavioral challenges that are related to HCV prevention.”
HIV Epidemic Progress and Opportunities
The national HIV AIDS strategy aims to end the epidemic by 2030 by reducing new infections by 75% in 2025 and by 90% in 2030. They also plan to increase linkage to care by 95% in 2025 and increase viral suppression to 95% in those who have an HIV diagnosis. A major focus area to achieve these goals is to increase PrEP coverage (preventive service that must be covered without additional cost to the patient, even before a deductible is met). While progress is being made, acceleration is needed.
“We can share joy in the fact that we have expanded HIV testing and rapid linkage to care for our patients who have been diagnosed with HIV,” said Bernard. “Increased access to anti-retroviral therapy helps patients achieve viral suppression, thereby reducing illness and transmission. The growth of PrEP for our pre-exposure prophylaxis programs and the syringe support system nationally are paving the way. There are also small growths within our personal health care system, such as the collaboration with a clinical pharmacist to help diagnose and treat our HIV patients. Some of the challenges we are facing are persistent stigma, discrimination and funding gaps, which create barriers to care and prevention, especially for these marginalized groups. I would say socioeconomic challenges are probably our greatest hurdle.”
How Clinical Pharmacists Bridge Care Gaps
Clinical pharmacists help identify patients in need of treatment for HCV and HIV and initiate medication therapies. They bridge the gap between screening the patient, identifying them as needing treatment and then attending to the patient until they get the desired clinical response. They support the treatment process while also supporting both the patient and the provider.
“They help me by figuring out the prior authorization process, which is more than I could ever imagine doing on my own,” said Bernard. “They counsel patients on medications, monitor their adherence and offer education. They are my lifeline to making sure we are meeting the targets of getting our patients treated to completion and I could not do it without them.”
“Our pharmacists take an open communication approach to get results. Being able to identify patients in a timely manner is critical. Once patients get away, it's very hard to get them back,” said McCormack.
“And follow-ups are crucial to letting them know what's going on. I’m going to do this for you. I'm going to get you that appointment. I'm going to navigate the insurance hurdles, find out what your copay is, get you financial assistance, whether it's from the state or from the manufacturer or a co-pay card. Whatever that is, I'll arrange for the medication to be here and I keep them in the loop the whole time,” said McCormack. “These open lines of communication between the lab, the provider and the patient and bringing that all together, so that everybody's on the same page, is crucial.”
“We have patients who are worried about the side effects, and our pharmacists do a lot of counseling to help alleviate those worries and keep them on track or help manage the side effects if they come about,” said Shih. “If a patient is not scheduled and their dosing window is coming up, we will reach out to ensure the patient is reminded about their appointment.”
To learn more about how Clearway Health clinical pharmacists are helping to close the gap on infectious diseases, watch the full webinar here.