The Impact of Pharmaceutical Care on the Efficacy of Direct-Acting Antivirals for Hepatitis C Patients at Mukdahan Hospital

Abstract

International studies have confirmed the efficacy of pharmaceutical care in the treatment of hepatitis C; however, data within the Thai context remain limited. Objective: This study aimed to compare the sustained virological response at 12 weeks (SVR12) between the pharmaceutical care (PC) group and the control group, and to evaluate, within the PC group, medication adherence, drug-related problems (DRPs), and safety. Methods: A quasi-experimental study with a historical control group was conducted among hepatitis C patients receiving direct-acting antivirals (DAAs) at the Hepatitis Clinic, Mukdahan Hospital. Patients were divided into a historical control group receiving standard care (1 August 2023 – 31 July 2024) and a PC group receiving pharmacist-delivered care (1 October 2024 – 30 September 2025), which comprised medication history review, patient education, assessment of medication adherence using the Medication Adherence Scale for Thais (MAST), identification and management of drug interactions, DRP management, and monitoring of adverse drug events (ADEs). Results: The PC group (n = 74) had an SVR12 rate of 98.65% compared with 97.18% in the control group (n = 71) (risk difference, 1.47%; 95% CI, -4.79 to 8.44). After adjusting for sex and baseline white blood cell count using multivariable logistic regression, SVR12 did not differ significantly between groups (adjusted OR, 2.25; 95% CI, 0.18–28.37; p = 0.532). The PC group demonstrated medication adherence (median MAST score = 40; IQR = 0; range, 35–40). Fifteen DRPs were identified in 14 patients (18.92%); all pharmacist interventions were accepted, and all DRPs were resolved. No severe ADEs (Grade 3–5) were observed. Conclusion: The SVR12 rate did not differ significantly between the PC and control groups. Within the PC group, patients demonstrated medication adherence, drug-related problems were fully resolved, and no severe adverse events were observed. However, these outcomes were not compared with the control group.