• Meng Hsuan Kuo, Chih-Wei Tseng, Chi-Hui Lee, Ya-Ching Yang, Hsin-Ju Wu, Hsiu-Ju Lin, Ya-Lan Chu, Yen-Chun Chen, and Kuo-Chih Tseng.
• Department of Pharmacy, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan.
• J Formos Med Assoc. 2022 Jan 1; 121 (1 Pt 1): 58-65.

Background/PurposeTo investigate the impact of pharmaceutical care programs for the management of contraindicated drug-drug interactions (DDIs) in direct-acting antivirals (DAAs) therapy.MethodsA prospective observational study was performed at Dalin Tzu Chi Hospital between January 2018 and December 2019. Pharmacists screened DDIs for all hepatitis C patients before DAA therapy. The study outcome included the frequency of contraindicated DDIs, acceptance rate, and cost avoidance of the pharmaceutical care program.ResultsA total of 1053 patients were enrolled in the study, with a mean age of 67.1 ± 11.9 years. Most patients received therapy with sofosbuvir/ledipasvir (37.1%; n = 391), elbasvir/grazoprevir (23.8%; n = 251), or glecaprevir/pibrentasvir (21.1%; n = 222). A total of 796 (75.6%) patients received at least one co-medication, with the average number of co-medications being 5.2 per patient (SD: 4.4/patient). In total, 1356 DDIs were identified, with the average DDIs per patient of 1.3 (SD: 1.7). For patients with contraindicated DDIs (2%, n = 102), statins and amiodarone were the most common co-medications. Physicians often accepted pharmacists' recommendations (acceptance rate of 72.5%) or withheld co-medication to avoid severe adverse drug events (ADEs). The estimated cost avoidance of preventable ADEs was USD 14,033 for contraindicated DDIs with pharmaceutical care programs.ConclusionThe implementation of pharmaceutical care programs in DAA therapy provides a favorable outcome and substantial cost avoidance.Copyright © 2021 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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