{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T09:55:38Z","timestamp":1793094938192,"version":"4.5.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T00:00:00Z","timestamp":1732838400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>Hepatitis C viral infection is a major public health concern and leading cause of chronic liver disease in the United States. Hepatitis C is primarily transmitted through blood exchange and is highly prevalent among people who inject drugs. Despite the availability of direct-acting antiviral (DAA) treatment, cost and barriers to access remain prohibitive for many patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Summary<\/jats:title>\n                  <jats:p>In 2018, University of Kentucky HealthCare (UKHC) began a screening program for patients admitted to its emergency department (ED). Despite identifying hepatitis C RNA\u2013positive patients, connection to care proved challenging due to unavailability of follow-up clinic appointments, communication barriers, and lack of insurance coverage. In 2023, UKHC implemented a pharmacist-led hepatitis C screening, assessment, and treatment initiative in the ED following American Association for the Study of Liver Diseases (AASLD) simplified treatment guidelines. Pharmacists order needed laboratory assessments and complete imaging for liver fibrosis in eligible patients. Patients diagnosed with hepatitis C who meet simplified treatment criteria are prescribed DAA therapy by a hepatitis C advanced practice provider employed by the program. The UKHC specialty pharmacy then follows up with dispensing of DAA therapy and proactive refill management for subsequent fills.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This holistic, interdisciplinary treatment model has allowed UKHC to increase treatment attachment rates for hepatitis C diagnoses in the ED from approximately 10% to 54%. This program has also reduced the median time to treatment of hepatitis C\u2013infected individuals encountered in the ED from approximately 420 days to 17 days.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajhp\/zxae373","type":"journal-article","created":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T23:12:27Z","timestamp":1732921947000},"page":"e551-e558","source":"Crossref","is-referenced-by-count":1,"title":["Implementation of a novel framework for hepatitis C diagnosis and treatment in an academic health system"],"prefix":"10.1093","volume":"82","author":[{"given":"Lindsey P","family":"Sheehan","sequence":"first","affiliation":[{"name":"Specialty Pharmacy and Infusion Services, UK HealthCare , Lexington, KY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maribeth P","family":"Wright","sequence":"additional","affiliation":[{"name":"Specialty Pharmacy and Infusion Services , UK HealthCare, Lexington, KY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Rhudy","sequence":"additional","affiliation":[{"name":"Specialty Pharmacy and Infusion Services, UK HealthCare , Lexington, KY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thai","family":"Osborne","sequence":"additional","affiliation":[{"name":"Specialty Pharmacy and Infusion Services, UK HealthCare , Lexington, KY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thom","family":"Platt","sequence":"additional","affiliation":[{"name":"Specialty Pharmacy and Infusion Services, UK HealthCare , Lexington, KY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah L","family":"Duckworth","sequence":"additional","affiliation":[{"name":"Specialty Pharmacy and Infusion Services, UK HealthCare , Lexington, KY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,11,29]]},"reference":[{"issue":"4","key":"2025052400121344100_CIT0001","doi-asserted-by":"crossref","first-page":"a036939","DOI":"10.1101\/cshperspect.a036939","article-title":"The elimination of hepatitis C as a public health threat","volume":"10","author":"Hellard","year":"2020","journal-title":"Cold Spring Harb Perspect Med"},{"issue":"suppl 3","key":"2025052400121344100_CIT0002","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1111\/jvh.13005","article-title":"The comprehensive outcomes of hepatitis C virus infection: a multi-faceted chronic disease","volume":"25","author":"Younossi","year":"2018","journal-title":"J Viral Hepat"},{"issue":"5","key":"2025052400121344100_CIT0003","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1002\/cld.1061","article-title":"Global epidemiology of chronic liver disease","volume":"17","author":"Cheemerla","year":"2021","journal-title":"Clin Liver Dis (Hoboken)"},{"key":"2025052400121344100_CIT0004","doi-asserted-by":"crossref","first-page":"15S","DOI":"10.1002\/hep.510260703","article-title":"Hepatitis C: the clinical spectrum of disease","volume":"26","author":"Hoofnagle","year":"1997","journal-title":"Hepatology"},{"key":"2025052400121344100_CIT0005","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad319","article-title":"Hepatitis C guidance 2023 update: AASLD-IDSA recommendations for testing, managing, and treating hepatitis C virus infection","author":"Bhattacharya","year":"25, 2023","journal-title":"Clin Infect Dis"},{"issue":"6","key":"2025052400121344100_CIT0006","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/S2468-1253(19)30085-8","article-title":"The contribution of injecting drug use as a risk factor for hepatitis C virus transmission globally, regionally, and at country level: a modelling study","volume":"4","author":"Trickey","year":"2019","journal-title":"Lancet Gastroenterol Hepatol"},{"issue":"5","key":"2025052400121344100_CIT0007","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1080\/09540121.2010.516346","article-title":"Injection risk behaviors among rural drug users: implications for HIV prevention","volume":"23","author":"Havens","year":"2011","journal-title":"AIDS Care"},{"key":"2025052400121344100_CIT0008","author":"National Institute on Drug Abuse, National Institutes of Health. Viral hepatitis. Published","year":"2020"},{"issue":"6","key":"2025052400121344100_CIT0009","first-page":"363","article-title":"Screening for hepatitis C virus infection in adolescents and adults: recommendation statement","volume":"102","year":"2020","journal-title":"Am Fam Physician"},{"issue":"20","key":"2025052400121344100_CIT0010","doi-asserted-by":"crossref","first-page":"1878","DOI":"10.1056\/NEJMoa1214853","article-title":"Sofosbuvir for previously untreated chronic hepatitis &lt;C infection","volume":"368","author":"Lawitz","year":"2013","journal-title":"N Engl J Med"},{"issue":"2","key":"2025052400121344100_CIT0011","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1053\/j.gastro.2018.10.024","article-title":"Status of direct-acting antiviral therapy for hepatitis C virus infection and remaining challenges","volume":"156","author":"Baumert","year":"2019","journal-title":"Gastroenterology"},{"issue":"2","key":"2025052400121344100_CIT0012","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1111\/jvh.12635","article-title":"Pan-genotypic treatment regimens for hepatitis C virus: advantages and disadvantages in high- and low-income regions","volume":"24","author":"Hezode","year":"2017","journal-title":"J Viral Hepat"},{"issue":"3","key":"2025052400121344100_CIT0013","doi-asserted-by":"crossref","first-page":"100001","DOI":"10.1016\/j.jve.2020.06.001","article-title":"Price of a hepatitis C cure: cost of production and current prices for direct-acting antivirals in 50 countries","volume":"6","author":"Barber","year":"2020","journal-title":"J Virus Erad"},{"issue":"6","key":"2025052400121344100_CIT0014","doi-asserted-by":"crossref","first-page":"343","DOI":"10.14740\/gr1568","article-title":"Barriers to hepatitis C virus care and how federally qualified health centers can improve patient access to treatment","volume":"15","author":"Lam","year":"2022","journal-title":"Gastroenterol Res"},{"key":"2025052400121344100_CIT0015","article-title":"2024 national snapshot","author":"Hepatitis C: State of Medicaid Access"},{"issue":"8","key":"2025052400121344100_CIT0016","first-page":"815","article-title":"Advancing patient care through specialty pharmacy services in an academic health system","volume":"23","author":"Bagwell","year":"2017","journal-title":"J Manag Care Spec Pharm"},{"issue":"12","key":"2025052400121344100_CIT0017","doi-asserted-by":"crossref","first-page":"3241","DOI":"10.1007\/s10620-018-5231-0","article-title":"Intensive pharmacy care improves outcomes of hepatitis C treatment in a vulnerable patient population at a safety-net hospital","volume":"63","author":"Tran","year":"2018","journal-title":"Dig Dis Sci"},{"key":"2025052400121344100_CIT0018","article-title":"Overview of viral hepatitis","author":"Centers for Disease Control and Prevention"},{"issue":"3","key":"2025052400121344100_CIT0019","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1097\/QAI.0000000000001098","article-title":"County-level vulnerability assessment for rapid dissemination of HIV or HCV infections among persons who inject drugs, United States","volume":"73","author":"Van Handel","year":"2016","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"4","key":"2025052400121344100_CIT0020","first-page":"123","article-title":"Access to health care in Appalachia: perception and reality","volume":"3","author":"Morrone","year":"2021","journal-title":"J Appalach Health"},{"issue":"1","key":"2025052400121344100_CIT0021","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s11606-020-06201-6","article-title":"\u201cHealth is on the back burner:\u201d multilevel barriers and facilitators to primary care among people who inject drugs","volume":"36","author":"Motavalli","year":"2021","journal-title":"J Gen Intern Med"},{"issue":"12","key":"2025052400121344100_CIT0022","doi-asserted-by":"crossref","first-page":"2236","DOI":"10.3390\/diagnostics11122236","article-title":"Assessing liver fibrosis using the FIB4 index in the community setting","volume":"11","author":"Blanco-Grau","year":"2021","journal-title":"Diagnostics (Basel)"},{"issue":"6","key":"2025052400121344100_CIT0023","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1108\/IJOPM-09-2020-0666","article-title":"Kaizen event process quality: towards a phase-based understanding of high-quality group problem-solving","volume":"41","author":"Franken","year":"2021","journal-title":"International Journal of Operations & Production Management"},{"issue":"4","key":"2025052400121344100_CIT0024","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1016\/j.cgh.2014.12.014","article-title":"Accuracy of Fibroscan, compared with histology, in analysis of liver fibrosis in patients with hepatitis B or C: a United States multicenter study","volume":"13","author":"Afdhal","year":"2015","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2025052400121344100_CIT0025","article-title":"Public Health Service Act of 1944. Section 340B Pub. L. 102-585 (1992)"}],"container-title":["American Journal of Health-System Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajhp\/advance-article-pdf\/doi\/10.1093\/ajhp\/zxae373\/60909943\/zxae373.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/article-pdf\/82\/11\/e551\/60909943\/zxae373.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/article-pdf\/82\/11\/e551\/60909943\/zxae373.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T04:12:20Z","timestamp":1748059940000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajhp\/article\/82\/11\/e551\/7913534"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,29]]},"references-count":25,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,29]]},"published-print":{"date-parts":[[2025,5,23]]}},"URL":"https:\/\/doi.org\/10.1093\/ajhp\/zxae373","relation":{},"ISSN":["1079-2082","1535-2900"],"issn-type":[{"value":"1079-2082","type":"print"},{"value":"1535-2900","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,6,1]]},"published":{"date-parts":[[2024,11,29]]}}}