THERAPEUTIC MONITORING AND PHARMACIST INTERVENTION IN A HANSENS-DISEASE CLINIC

OBJECTIVE: To describe the role of the clinical pharmacist in a Hansen 's disease (HD, leprosy) clinic and to describe the development, valid ation, and operation of a dapsone compliance monitoring program. RATIO NALE: HD remains a major, worldwide healthcare problem Dapsone is the drug of choice for treatment of HD; however, high rates of noncomplian ce with this agent have been reported by many treatment centers. The a ssessment of compliance in HD patients is important to help distinguis h between treatment failure secondary to noncompliance or to the devel opment of resistance. SETTING: In the US, the Chicago Regional Hansen' s Disease Center at the University of Illinois at Chicago is one of te n centers that provide comprehensive care to patients diagnosed with t his condition. This article reviews the clinical pharmacy services and dapsone compliance program in the clinic encompassing the years 1982- 93. RESULTS: The clinical pharmacist provides a variety of clinical se rvices in the clinic as well as coordinating the clinical research pro gram. A pharmacist-generated dapsone compliance program led to improve ment in compliance rates and clinical outcome. This improvement in com pliance has been sustained over an extended period of time. CONCLUSION S: The clinical pharmacy services performed in the HD clinic provide a model for pharmacy involvement in other chronic disease states. The d apsone compliance program has been successful in improving patient car e and obtaining reimbursement for clinical pharmacy services.