Over 3 million people in the United States are living with chronic hepatitis C viral (HCV) infection. Psychiatric illnesses are considered a barrier to achieving sustained virological response (SVR) in patients with HCV but early detection and treatment of depression can improve antiviral adherence. Depressive disorder is a commonly existing comorbidity of HCV, with an estimated prevalence of 14%. Insomnia is associated with specific direct-acting antivirals (DAAs), requiring treatment for some during the 12-24 weeks of treatment and post-treatment surveillance. Psychiatric pharmacists can help improve adherence with antiviral medications by concomitantly managing psychiatric symptoms and monitoring symptom response. In addition to performing baseline psychiatric evaluations and managing interferon-induced psychiatric symptoms, psychiatric pharmacists should provide patient education on HCV and the antiviral medications, and manage drug-drug interactions prior to initiating DAAs.
These tables/tools can be used as part of the training for psychiatric pharmacists to perform the basic duties of a clinical hepatic pharmacist, while influencing psychiatric care for patients infected with HCV who require antiviral treatment.
For additional information on the medications and HCV-related tools and calculators, please go to Hepatitis C Online.
This toolkit was authored by CPNP member Susie H. Park, PharmD, BCPP, FCSHP. It has been adapted from a resource original created for the CPNP 2018 session A Complicated Relationship: Depression, Insomnia, and Hepatitis C. That ACPE-accredited session will be available online until April 2021.
