02398nas a2200325 4500000000100000008004100001260001300042653002900055653001200084653001600096653001200112653002000124653001100144653001200155653002200167653002300189653003100212653001300243100001900256700001900275700001700294700001100311700001300322700001600335245008500351300001200436490000700448520160300455022001402058 1993 d c1993 Dec10aAcademic Medical Centers10aChicago10aClofazimine10aDapsone10aDrug Monitoring10aHumans10aleprosy10aPatient Care Team10aPatient Compliance10aPharmacy Service, Hospital10aRifampin1 aPiscitelli S C1 aOcchipinti D J1 aDanziger L H1 aHill C1 aWest D P1 aFischer J H00aTherapeutic monitoring and pharmacist intervention in a Hansen's disease clinic. a1526-310 v273 a

OBJECTIVE: To describe the role of the clinical pharmacist in a Hansen's disease (HD, leprosy) clinic and to describe the development, validation, and operation of a dapsone compliance monitoring program.

RATIONALE: HD remains a major, worldwide healthcare problem. Dapsone is the drug of choice for treatment of HD; however, high rates of noncompliance with this agent have been reported by many treatment centers. The assessment of compliance in HD patients is important to help distinguish between treatment failure secondary to noncompliance or to the development of resistance.

SETTING: In the US, the Chicago Regional Hansen's Disease Center at the University of Illinois at Chicago is one of ten centers that provide comprehensive care to patients diagnosed with this condition. This article reviews the clinical pharmacy services and dapsone compliance program in the clinic encompassing the years 1983-93.

RESULTS: The clinical pharmacist provides a variety of clinical services in the clinic as well as coordinating the clinical research program. A pharmacist-generated dapsone compliance program led to improvement in compliance rates and clinical outcome. This improvement in compliance has been sustained over an extended period of time.

CONCLUSIONS: The clinical pharmacy services performed in the HD clinic provide a model for pharmacy involvement in other chronic disease states. The dapsone compliance program has been successful in improving patient care and obtaining reimbursement for clinical pharmacy services.

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