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Impact of a digital medicine programme on hepatitis C treatment adherence and efficacy in adults at high risk for non-adherence.

Publication ,  Journal Article
Sulkowski, M; Luetkemeyer, AF; Wyles, DL; Martorell, C; Muir, A; Weisberg, I; Gordon, SC; McLain, R; Huhn, G
Published in: Aliment Pharmacol Ther
June 2020

BACKGROUND: Direct-acting anti-virals (DAA) are highly effective for hepatitis C virus (HCV) treatment, but perceived risks of medication non-adherence may restrict access to care. Digital medicine programme (DMP) has improved adherence and outcomes for some conditions. AIMS: To conduct a prospective, single-arm, open-label study across the United States to assess the impact of DMP on adherence and efficacy in adults with chronic HCV infection at high risk for non-adherence. METHODS: Eligible participants were placed on the DMP to evaluate real-time adherence; primary outcome was sustained virological response (SVR) at ≥10 weeks post-treatment. RESULTS: Between August 2017 and April 2019, 288 participants (Medicaid, 64.9%; psychiatric disorders, 61.1%; homeless, 9.4%) received DAAs for 8-12 weeks (sofosbuvir/velpatasvir or ledipasvir, 45%; glecaprevir/pibrentasvir, 55%). SVR was achieved in 99.1% of 218 participants who had HCV RNA assessed at ≥10 weeks post-treatment; of the 70 participants who did not have SVR assessed, 17 had SVR4 with HCV RNA assessed at a median (IQR; interquartile range) 5.6 weeks (4.1, 7.9) post-treatment; one completed treatment but did not have HCV RNA assessed, and 52 discontinued treatment early without assessment. Overall, the primary analysed participants (n = 218) actively used the DMP for median (range) 92.9% (12.5%, 100%) of their prescribed treatment time, and overall pill-taking adherence was 95.0% (57.1%, 100%). Participants reported the programme was useful and easy to use through satisfaction surveys. CONCLUSIONS: HCV treatment with DMP was accepted by patients and clinicians and may support HCV treatment outcomes among patients at high risk for treatment non-adherence (Clinical trials.gov NCT03164902).

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Published In

Aliment Pharmacol Ther

DOI

EISSN

1365-2036

Publication Date

June 2020

Volume

51

Issue

12

Start / End Page

1384 / 1396

Location

England

Related Subject Headings

  • United States
  • Treatment Outcome
  • Telemedicine
  • Sustained Virologic Response
  • Risk Factors
  • Prospective Studies
  • Program Evaluation
  • Patient Compliance
  • Patient Acceptance of Health Care
  • Middle Aged
 

Citation

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Chicago
ICMJE
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Sulkowski, M., Luetkemeyer, A. F., Wyles, D. L., Martorell, C., Muir, A., Weisberg, I., … Huhn, G. (2020). Impact of a digital medicine programme on hepatitis C treatment adherence and efficacy in adults at high risk for non-adherence. Aliment Pharmacol Ther, 51(12), 1384–1396. https://doi.org/10.1111/apt.15707
Sulkowski, Mark, Annie F. Luetkemeyer, David L. Wyles, Claudia Martorell, Andrew Muir, Ilan Weisberg, Stuart C. Gordon, Richard McLain, and Gregory Huhn. “Impact of a digital medicine programme on hepatitis C treatment adherence and efficacy in adults at high risk for non-adherence.Aliment Pharmacol Ther 51, no. 12 (June 2020): 1384–96. https://doi.org/10.1111/apt.15707.
Sulkowski M, Luetkemeyer AF, Wyles DL, Martorell C, Muir A, Weisberg I, et al. Impact of a digital medicine programme on hepatitis C treatment adherence and efficacy in adults at high risk for non-adherence. Aliment Pharmacol Ther. 2020 Jun;51(12):1384–96.
Sulkowski, Mark, et al. “Impact of a digital medicine programme on hepatitis C treatment adherence and efficacy in adults at high risk for non-adherence.Aliment Pharmacol Ther, vol. 51, no. 12, June 2020, pp. 1384–96. Pubmed, doi:10.1111/apt.15707.
Sulkowski M, Luetkemeyer AF, Wyles DL, Martorell C, Muir A, Weisberg I, Gordon SC, McLain R, Huhn G. Impact of a digital medicine programme on hepatitis C treatment adherence and efficacy in adults at high risk for non-adherence. Aliment Pharmacol Ther. 2020 Jun;51(12):1384–1396.
Journal cover image

Published In

Aliment Pharmacol Ther

DOI

EISSN

1365-2036

Publication Date

June 2020

Volume

51

Issue

12

Start / End Page

1384 / 1396

Location

England

Related Subject Headings

  • United States
  • Treatment Outcome
  • Telemedicine
  • Sustained Virologic Response
  • Risk Factors
  • Prospective Studies
  • Program Evaluation
  • Patient Compliance
  • Patient Acceptance of Health Care
  • Middle Aged