Given the high efficacy rates of DAA treatment in patients following NAT+ HCT SOT in HCV-recipients, little data is available to guide retreatment selection. This study aims to fill this gap by polling data from multiple treatment sites, assessing the retreatment strategies and SVC rates of said strategies.

The purpose of this quality improvement project was to implement a transparent, streamlined process of managing patients with IBD receiving specialty medications that have complex dosing regimens with IV to SubQ routes of administration. This was achieved by implementing an EHR flowsheet for patient management and care coordination between infusion and specialty pharmacy staff.

This dual site retrospective study evaluated deutetrabenazine for the treatment of HD chorea at doses above current FDA approval. Deutetrabenazine >48 mg daily appears safe and well tolerated in patients with uncontrolled HD chorea, though no significant change in total maximal chorea score was found. Psychiatric changes were less commonly reported at doses >48 mg/day, but extrapyramidal symptoms were more common. The median PDC was 0.99 and only 2 patients discontinued due to AEs.

Many barriers prevent individuals with substance use disorders from receiving hepatitis C virus (HCV) treatment. This study describes 96 patients with active HCV treated in an opioid use disorder bridge clinic model. Of 33 patients who initiated treatment, 25 patients completed treatment, and 13 patients achieved sustained virologic response.

In a cohort study of 61 patients prescribed risankizumab (RZB) for Crohn's Disease more frequently than the FDA approved dose, almost half had improvement. There was a trend suggesting patients who failed multiple advanced therapies were less likely to improve. A third (33%) of patients had additional medication changes. With available data, improvements were seen in CRP (54%), ESR (46%), and HBI (56%) measures. This study provides the largest cohort of escalated dosing in RZB.

This single-center, retrospective review evaluated medication outcomes and time to access therapy in patients using step therapy or formulary alternatives after being prescribed specialty medications for psoriasis or atopic dermatitis. Most patients denied specialty medications due to insurance requirements eventually needed them or were lost to follow-up (n=37; 60%). Only 5 patients (8%) benefited from and remained on step therapy.

This study described the care coordination process and patient outcomes from decision to treat with ustekinumab through initiating subcutaneous (SQ) injection. Prescriptions filled with Vanderbilt Specialty Pharmacy (VSP) had 2.5 times higher odds of being shipped in the appropriate window compared to non-VSP with 56% dose-escalated during the first year. This study shows ustekinumab initiation and escalation in the first year can be a lengthy process requiring a high level of care coordination.

This study quantified VSP pharmacists’ work performed to facilitate specialty medication education, access, adherence, and persistence for patients who do not use VSP. Across 3 clinics over 5 months, pharmacists performed 1,645 actions for 714 non-VSP patients, equating to 375 hours and $30,429.48 in estimated pharmacist compensation. Lack of visibility in the patient journey and increased workload on providers and health systems is created when payers and manufacturers lockout IHSSPs.

This quality improvement project aims to evaluate implementation of a standardized process for specialty pharmacists to document and monitor patient disease severity and response to therapy using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ), a patient reported outcome, administered via the electronic health record patient portal.

This study evaluated treatment outcomes (adherence, persistence, switching and discontinuation of therapy) and pharmacists' management of adverse events (AE's) in patients on an oral oncolytic for CLL/SLL. In a population of patients initiating oral CLL/SLL therapy through an integrated Health-System Pharmacy, adherence to therapy was high (mean PDC 92%). Adverse effects led to 36% of therapy discontinuations and 72% of therapy switches, indicating an opportunity for pharmacists to manage AE's.