Enhanced adherence to HCV therapy with higher dose ribavirin formulation: final analyses from the ADHERE registry

Alam, Imtiaz; Stainbrook, Tuesdae; Cecil, Bennet D.; Kistler, Kristen D.

doi:10.1111/j.1365-2036.2010.04381.x

Cited by 11 publications

(19 citation statements)

References 29 publications

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“…The extent to which patients miss doses (i.e., medication nonadherence) of IFN/RBV during HCV treatment has been examined in only a handful of studies using self-report, pharmacy refill data, pill counts, and electronic monitoring caps 6, 10–16 . Collectively, these studies show that (a) patients miss doses, particularly the twice daily oral RBV tablets; (b) the proportion of missed doses increases over time; and (c) missed doses are associated with worse virological response to treatment.…”

Section: Introductionmentioning

confidence: 99%

Self-Efficacy and Adherence to Antiviral Treatment for Chronic Hepatitis C

Bonner

Esserman²,

Golin³

et al. 2015

Journal of Clinical Gastroenterology

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Goals Investigate the role of self-efficacy during HCV treatment. Background Adherence to chronic hepatitis C virus (HCV) treatment is critical. Self-efficacy (SE) is an important predictor of medication adherence in a number of chronic disease populations and medication regimens, but its role during HCV treatment remains unknown. Study Data from the prospective Virahep-C study was analyzed to examine relationships between SE and patient-driven deviations (i.e., missed doses measured using electronic pill caps, and nonpersistence) from adherence to HCV antiviral treatment. SE was measured using the 17-item HCV Treatment Self-Efficacy scale. This measure provides a global estimate of a patient’s confidence to undergo and adhere to HCV treatment, and can estimate SE in four underlying domains: communication SE (i.e., confidence to communicate with healthcare provider), physical coping SE (i.e., confidence to cope with physical side effects), psychological coping SE (i.e., confidence to cope with psychiatric side effects), and treatment adherence SE (i.e., confidence to take all medication as prescribed and attend doctor visits). Generalized estimating equations and Cox proportional hazards models were used to assess associations between SE and missed doses and nonpersistence, respectively. Results SE was associated with being in a relationship, educated, privately insured, and less depressed. Higher communication SE at TW24 reduced the risk of missed doses between TW24 and 48. Higher baseline treatment adherence SE reduced the likelihood of nonpersistence between baseline and TW24. Conclusions Self-efficacy’s relationship to HCV treatment adherence has promising clinical and research implications.

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Section: Introductionmentioning

confidence: 99%

Self-Efficacy and Adherence to Antiviral Treatment for Chronic Hepatitis C

Bonner

Esserman²,

Golin³

et al. 2015

Journal of Clinical Gastroenterology

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“…Patients undergoing HCV treatment can have issues with both medication persistence (i.e., persisting on the full course of antiviral therapy) and medication adherence, (i.e., taking all of the medications exactly as prescribed without missed doses). Previous research, including that conducted by our group, demonstrates that HCV patients can have difficulty taking their medications as prescribed, nonadherence worsens over the course of treatment, and is linked to lower virological response and sustained virological response (SVR) (1, 2, 5, 6). Notably, patients have a more difficult time dosing oral antiviral medications, such as ribavirin (RBV), compared to dosing once a week self-injection of pegylated interferon (PegIFN).…”

Section: Introductionmentioning

confidence: 98%

“…While previous quantitative studies describe the pattern and prevalence of medication nonadherence during HCV treatment (2, 5, 6), exactly how and why patients do or do not take their HCV medications as prescribed remains unclear. Although previous adherence research with medication regimens for other patient populations has been cited, there may be more dissimilarities than commonalities among these regimens and populations (7, 8).…”

Section: Introductionmentioning

confidence: 99%

Adherence During Antiviral Treatment Regimens for Chronic Hepatitis C

Evon¹,

Golin²,

Bonner³

et al. 2015

Journal of Clinical Gastroenterology

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Goals To understand patients’ perceptions of factors which facilitate and hinder adherence in order to inform adherence-enhancing interventions. Background Adherence to antiviral therapy for hepatitis C viral infection is critical to achieving a sustained virological response (SVR). However, persistence with and adherence to antiviral regimens can pose challenges for patients that interfere with SVR. Study A qualitative analysis of 21 semi-structured patient interviews using open-ended questions and specific follow-up probes was conducted. Interviews were audio-recorded, transcribed, and content-analyzed iteratively to determine frequent and salient themes. Results Three broad themes emerged: 1) missing doses and dose-timing errors; 2) facilitators of adherence; and 3) barriers to adherence. Open-ended questioning revealed few dose-timing deviations, but more specific probes uncovered several more occurrences of delays in dosing. Facilitators of adherence fell into two broad categories: (a) patient knowledge and motivation and (b) practical behavioral strategies and routines. Facilitators were noted post hoc to be consistent with the Information-Motivation-Behavioral Skills Model of Adherence. Barriers to adherence involved changes in daily routine, being preoccupied with family or work responsibilities, and sleeping through dosing times. A few patients reported skipping doses due to side effects. Patients with previous HCV treatment experience may have fewer dose-timing errors. Finally, a high level of anxiety amongst some patients was discovered regarding dosing errors. Emotional and informational support from clinical and research staff was key to assuaging patient fears. Conclusions This qualitative study improves our understanding of patients’ perspectives regarding adhering to hepatitis C treatment and can lead to the development of adherence-enhancing interventions.

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“…63 Other treatment-related factors such as pill burden, ease of use of injection device, and frequency of injection also improve adherence to CHC therapy. 66,69,70 A study looking specifically at timing of health outcomes showed that patients with CHC have a strong preference to expedite an expected interval of poor health such as one encountered by most patients undergoing interferon-based therapy regardless of the outcome of therapy. 71 In summary, prior experience with CHC therapy illustrates that patients have strong preferences related to therapy and these preferences have a significant impact on efficacy of therapy.…”

Section: Patient Preferencementioning

confidence: 99%

“…Many studies have shown that outside of clinical trials, both patient-related factors as well as treatment-related factors limit the efficacy of therapy. [61][62][63][64][65][66] It is clear that patient preference is correlated with adherence to the treatment regimen which in turn greatly effects success of therapy. [66][67][68][69] While the ability to achieve SVR was found to be the most important characteristic of a treatment regimen to patients, Hauber and colleagues also found that patients were willing to accept a lower probability of achieving SVR to reduce side effects of treatment.…”

Section: Patient Preferencementioning

confidence: 99%

The Era of Direct-Acting Antivirals: The Evolving Role of Interferon and Ribavirin for the Treatment of chronic Hepatitis C

Gaetano

Desai

Reau

2012

Clinical Medicine Insights: Therapeutics

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Abstract:The burden of disease related to chronic hepatitis C (CHC) continues to increase annually. While our experience with treating CHC began less than 30 years, steady progress has been made in the ability to successfully treat patients, reducing morbidity and mortality. Until recently, the main players in therapy of CHC were interferon and ribavirin. Unfortunately, response to this therapy is successful only in a selected group of patients, leaving a sizeable portion of patients with CHC untreated or with ineffective retreatment options after having failed prior therapy. An in depth understanding of the hepatitis C virus has ushered in the dawn of a new era of therapy for CHC. Two drugs, telaprevir and boceprevir, have recently been approved by the Food and Drug Administration. Many others hold great promise and are in the early phases of drug development. Here, we will review the history of hepatitis C therapy, mechanism of action drugs approved for or in development, current data on clinical safety and efficacy of these agents as well as the role of patient preference in CHC therapy. We will conclude with current recommendations for the treatment of patients with CHC and the evolving role of interferon and ribavirin.

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Enhanced adherence to HCV therapy with higher dose ribavirin formulation: final analyses from the ADHERE registry

Cited by 11 publications

References 29 publications

Self-Efficacy and Adherence to Antiviral Treatment for Chronic Hepatitis C

Self-Efficacy and Adherence to Antiviral Treatment for Chronic Hepatitis C

Adherence During Antiviral Treatment Regimens for Chronic Hepatitis C

The Era of Direct-Acting Antivirals: The Evolving Role of Interferon and Ribavirin for the Treatment of chronic Hepatitis C

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