May is Hepatitis C (Hep C) Awareness Month and Shields is proud to support over 5000 patients with Hep C across the country. At Shields, improving lives and elevating performance are at the heart of everything we do, which is why it's important that we show our support and drive better outcomes for all patients. We sat down with two of our Clinical Pharmacists, Paul Rainville and Danielle Jackson, to learn more about their experience helping patients. 

Paul Rainville, PharmD, CSP: I graduated from MCPHS University in 2016 and have been working as a pharmacist since. I was drawn to specialty pharmacy when I saw some of my family members struggling to understand their complex medications for diseases such as diabetes and oncology. I've always wanted to give back to my community and being a Shields Pharmacist lets me help people feel comfortable with their most complicated treatment regimens.

Danielle Jackson, PharmD,BCMTM: I have been a pharmacist for almost 14 years, receiving my PharmD from the University of Rhode Island and most recently completing my board certification in Medication Therapy Management this past winter. I always knew I wanted to be in healthcare and felt drawn to the pharmacy industry at a very young age. I have had the pleasure of joining the Shields Team, going on two years now as a clinical pharmacist. I also took on the role of Infectious Disease Subject Matter Expert for our communities of practice.

Q: Tell us a bit about your experience in working with patients with Hep C.  

PR: I have been working with patients with Hepatitis C for five years as a pharmacist and even before that while interning in an HIV/Hep C specialty pharmacy. It has been an incredible journey seeing the transformation with Shields working collaboratively as part of the patient’s care team. We have the ability to increase patient’s success in achieving a cure!

DJ: I have been working closely with HepC patients since I began here at Shields. It is one of my favorite patient populations because we get to talk about a short-term course of medication that results in cure. Having this conversation always feels positive and life-changing for my patients.

Q. What have you found to be the most rewarding part of working with patients with Hep C? 

PR: The most rewarding part of working with patients with Hep C is seeing them get to the end of their treatment with a Sustained Viral Response , ultimately meaning they are cured. It is gratifying to teach and guide people through their treatment course and help them get to that point. Hep C is one of the few disease states we work with that is curable, and seeing patients get to that stage gives me an amazing rush.

DJ: I have found the initial discussion to be the most rewarding. I love engaging my patients, assuring them that I am available to help them stay on track and adherent to their therapy to achieve this goal and ultimately feel better and live longer.

Q: In your experience what are some of the biggest challenges patients with Hep C encounter both getting onto treatment and staying on treatment? 

PR: Some challenges I’ve seen are patients’ not receiving enough education about Hepatitis C, its available treatments, and options for financial assistance. Many fear the stigma associated with the disease as well as the impact on activities of daily living while undergoing treatment.

DJ: A lot of my patients are concerned that they will not be able to tolerate their medications or that they might get in the way of being able to continue working. Some are concerned that they won't be able to afford their medications to complete the whole therapy. Others simply have difficulty getting to the clinic appointments and labs to allow them to refill on time. 

Q: How do you feel the Shields Care Model helps break down the challenges mentioned above? 

PR: Our team’s ability to educate patients about their medication and the virus itself is often crucial to getting a patient committed to taking one of these treatments. Often many patients do not believe they have the virus because they don’t feel any symptoms. Teaching them about the virus and how it works can be just as important as teaching about their treatment regimen. The Shields Care Model gives patients the access they need to our pharmacy team to get the correct information and strengthen their commitment to understanding the goals of therapy.

DJ: The Shields collaborative team approach to helping and communicating with patients is the key to our patients' successes. Providing education on the disease, strategies to improve tolerance, and calls to stay on top of refills and address concerns quickly leads to a better quality of life and quality of treatment. We develop personal relationships with our patients and get to know them and their routines, which allows us to take that time and tailor the therapy timing and success for the individual patient. Many patients have other comorbidities and need to be on other medications at the same time. There are often interactions, and it's crucial that we identify these and plan for the total management of the patient during their HepC treatment course.

Q: What else, if anything, would be helpful for our peers to know about Hep C as related to Specialty Pharmacy? 

PR: There has been a significant shift in the treatment of Hepatitis C. In the past, a hepatologist would be the primary provider to prescribe and oversee the treatment regimen. We are now seeing providers from different fields (i.e. primary care and addiction medicine) take over as the primary prescriber for their patient’s Hepatitis C regimen. The increased variety of providers have allowed specialty pharmacists play a more significant role in optimizing treatment regimens and improve patient outcomes.

DJ: Many patients are looking for increased communication from their healthcare teams. The Shields Care Model is ideal for filling in the gaps that can happen so often in polypharmacy. We are the bridge between the patient, medication information, providers, and overall treatment success. As a specialty pharmacist, identifying any potential adherence concerns (from cost to fear of treatment or drug interactions), addressing these early, and providing helpful and personalized consultations, means the difference between a failed or a successful treatment to cure.