提高回覆C肝新藥交互作用效率之方案

Program to Improve Efficiency of Seeking Information on Interactions of New Drugs for Hepatitis C

目前C型肝炎治療仍無有效疫苗可預防，但近年來有突破性發展，從單一傳統干擾素（interferon）到長效型干擾素（peginterferon alfa，PegIFN）併用雷巴威林（ribavirin，RBV），又進展為直接作用抗病毒藥品（direct-acting antiviral agents, DAAs），讓評估慢性C型肝炎治療成效指標之持續病毒學反應 （sustained virologic response, SVR）比率達到90%以上。但因直接作用抗病毒藥品價格昂貴，又容易有交互作用，故如何提高藥師回覆交互作用的效率，是必須努力的方向。我們採用APP軟體與廠商諮詢專線取代原本的Micromedex查詢，改善後發現能有效縮短查詢時間，病人滿意度從3.2±0.7分，上升至4.6±0.4分（P值=0.04）。藥師滿意度也從3.1±0.4分，上升至4.8±0.2分（P值=0.02）。 A vaccine against hepatitis C virus (HCV) has yet to be developed. However, the development of treatments for chronic HCV infection has accelerated over the past few years; rapid progress has been made from traditionally prescribed single interferon medication to combined pegylated interferon and ribavirin, and finally to direct-acting antivirals (DAAs). Patients treated with DAAs have exhibited a sustained virologic response rate of 90%; however, oral DAA regimens are expensive and frequently interact with other drugs. Thus, pharmacists require an effective method to avoid dispensing drugs that interfere with one another. In this study, we proposed the use of a smartphone APP and drug counseling hotline for seeking information on drug interactions to replace the Micromedex and effectively shorten search times. We found that patient satisfaction increased from 3.2 ± 0.7 to 4.6 ± 0.4 points (P = 0.04). In addition, pharmacist satisfaction increased from 3.1 ± 0.4 to 4.8 ± 0.2 points (P = 0.02).