Measuring Adherence to Hepatitis C Direct-Acting Antiviral Medications: Using the VAS in an HCV Treatment Clinic

Burton, Mary Jane; Voluse, Andrew C.; Patel, Amee B.; Konkle‐Parker, Deborah

doi:10.14423/smj.0000000000000750

Cited by 12 publications

(7 citation statements)

References 51 publications

(41 reference statements)

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“…There was a high adherence to antiviral treatment observed in our study, as has been documented in previous studies,43 without differences by drug regimen, and therefore the effectiveness and safety shown by our results were not biased by patients not receiving the intervention. However, surprisingly, a higher incidence of DDIs was observed with SOF/VEL±RBV than with GLE/PIB.…”

Section: Discussionsupporting

confidence: 83%

Effectiveness and safety of sofosbuvir/velpatasvir ± ribavirin vs glecaprevir/pibrentasvir in genotype 3 hepatitis C virus infected patients

et al. 2020

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ObjectivesSofosbuvir/velpatasvir±ribavirin (SOF/VEL±RBV) and glecaprevir/pibrentasvir (GLE/PIB) are the drug combinations of choice for treating individuals with genotype 3 hepatitis C virus (G3-HCV) infection. The objective of this study was to evaluate the effectiveness and safety of SOF/VEL±RBV compared with GLE/PIB for treating G3-HCV infection under routine clinical practice conditions.MethodsWe conducted a prospective observational cohort study of individuals with G3-HCV infection who initiated treatment with SOF/VEL +/-RBV or GLE/PIB between April 2017 and July 2018. Prisoners and children were excluded. The outcome variable of effectiveness was sustained virological response 12 weeks after completing treatment (SVR12). The safety variable was withdrawal secondary to severe adverse events (SAEs). Covariates included sex, age, HIV co-infection, previous liver transplant, cirrhosis, hepatic fibrosis and previous antiviral treatment. Statistical significance was calculated using Fisher’s exact test or the Mann–Whitney U-test.ResultsA total of 76 patients were included in the analysis, of whom 46 were treated with SOF/VEL±RBV and 30 were treated with GLE/PIB. No baseline differences were observed between treatment groups with respect to age, sex, HIV co-infection, fibrosis stage, cirrhosis and previous antiviral treatment. Of the patients treated with SOF/VEL±RBV and GLE/PIB, 95.7% and 96.7% reached SVR12, respectively (P=0.7). Of patients with and without cirrhosis, 83.3% and 98.4% reached SVR12, respectively (P=0.09). Of the patients with low-grade hepatic fibrosis (F0-2) and advanced fibrosis (F3-4), 100% and 85.7% reached SVR12, respectively (P=0.03). In treatment-naïve and treatment-experienced patients, 95.7% and 100% reached SVR12, respectively (P=0.57), without significant differences independent of the treatment group (P=0.28 for SOF/VEL±RBV; P=0.18 for GLE/PIB). The incidence of AEs was 21.1% (95% CI 11.3% to 30.9%). None of the patients developed an SAE or required antiviral treatment withdrawal.ConclusionsSOF/VEL±RBV or GLE/PIB are safe and effective for treating G3-HCV-infections, with a lower effectiveness in patients with advanced fibrosis F3-4.

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Section: Discussionsupporting

confidence: 83%

Effectiveness and safety of sofosbuvir/velpatasvir ± ribavirin vs glecaprevir/pibrentasvir in genotype 3 hepatitis C virus infected patients

et al. 2020

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“…We found that perfect DAA adherence among PWID on MOUD as measured by a VAS was congruent with an objective, behavioural measure of adherence (blister pack) in terms that individuals who reported perfect adherence also showed greater adherence in blister pack data. Recent studies have demonstrated that self‐reported measures of DAA adherence provide similar results to behavioural measures, including pill counts and pharmacy dispensing, among people infected with HCV, some of which being PWID 5,14 . This study contributes to the existing literature on the utility of self‐reported measures as an indicator of adherence and expands these findings among PWID maintained on MOUD with recent drug use and by using a more accurate measure of objective adherence (ie electronic blister packs).…”

Section: Resultsmentioning

confidence: 54%

Rates of perfect self‐reported adherence to direct‐acting antiviral therapy and its correlates among people who inject drugs on medications for opioid use disorder: The PREVAIL study

Pericot‐Valverde

Rennert

Heo

et al. 2020

Journal of Viral Hepatitis

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Adequate adherence to direct‐acting antivirals (DAAs) for hepatitis C virus (HCV) is critical to attaining sustained virologic response (SVR). In this PREVAIL study's secondary analyses, we explored the association between self‐reported and objective DAAs adherence among a sample of people who inject drugs (PWID) receiving medications for opioid use disorder (MOUD) (N = 147). Self‐reported adherence was recoded 3 times during treatment (weeks 4, 8 and 12) using a visual analog scale (VAS), whereas objective adherence was collected continuously during treatment using electronic blister packs. Participants who reported being perfectly adherent had significantly higher blister pack adherence in each period (weeks 4, 8 and 12; ps < .05) and over the 12‐week study (p < .001) compared to those who reported being non‐perfectly adherent. Whites were more likely to report perfect adherence (91.7%) than Blacks (48.7%), Latinos (52.2%) and other (75.0%) race groups. Participants who reported recent use of cocaine (63.9%) or polysubstance use (60.0%) and those who had a positive result for cocaine (62.8%) were more likely to be non‐perfectly adherent, although none of these factors were associated with blister pack adherence. This study showed that the VAS could serve as a reliable option for assessing DAAs adherence among PWID on MOUD. The implementation of VAS may be an ideal option for monitoring adherence among PWID on MOUD, especially in clinical settings with limited resources. PWID on MOUD who are Black or other races than White, as well as those who report recent cocaine or polysubstance use may require additional support to maintain optimal DAA adherence.

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“…A VAS has been demonstrated to be a reliable option for assessing the adherence of patients to taking antiviral drugs. [18][19][20] Patients with high adherence (self-graded adherence >9) accounted for 46.4% of patients in the present study. According to studies conducted in China and other countries, the prevalence of adherence to NUC therapy in CHB patients ranges from 53.6% to 99%, and that for selfreporting of adherence to NUC therapy varies from 53.6% to 84%.…”

Section: Discussionmentioning

confidence: 60%

Treatment Adherence to Nucleos(t)ide Analogs in Chinese Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma: A Single-Center Cross-Sectional Study

Li¹,

Chen²,

Wang³

et al. 2021

PPA

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Purpose Chronic hepatitis B virus (HBV) infection is a crucial risk factor in the occurrence and development of hepatocellular carcinoma (HCC). Antiviral therapy is very important for patients with HBV-related HCC. To maintain undetectable level of HBV DNA, patients must take nucleos(t)ide analogues (NUCs) appropriately and regularly. We explored the adherence of Chinese patients with HBV-related HCC to antiviral treatment. Patients and Methods One-hundred and eighty-one patients were included in a cross-sectional study between August 2020 and February 2021. A structured questionnaire was used to interview patients, and a form was applied to collect data from electronic medical records. Medication adherence was measured using a visual analog scale. Data of the adherent group and non-adherent group were compared using Student’s t -test and the chi-square test. Multivariate logistic regression analysis was employed to explore independent risk factors that affected adherence behavior. Results High adherence was reported in 46.4% of patients with HBV-related HCC. Patients with high adherence were more likely to be women (P = 0.02), shun alcohol (P = 0.01), take NUCs other than entecavir (P = 0.04), and pay attention to their titer of HBV DNA (P = 0.05). Sex, alcohol consumption, and taking entecavir were independent risk factors for low adherence (P < 0.05). The prevalence of virological breakthrough was lower in patients who adhered to NUC therapy than in those who did not, but the difference was not significant (P = 0.31). Conclusion The adherence of patients with HBV-related HCC to NUC therapy was low. More attention should be paid to adherence of antiviral therapy in patients with HBV-related HCC.

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Measuring Adherence to Hepatitis C Direct-Acting Antiviral Medications: Using the VAS in an HCV Treatment Clinic

Cited by 12 publications

References 51 publications

Effectiveness and safety of sofosbuvir/velpatasvir ± ribavirin vs glecaprevir/pibrentasvir in genotype 3 hepatitis C virus infected patients

Effectiveness and safety of sofosbuvir/velpatasvir ± ribavirin vs glecaprevir/pibrentasvir in genotype 3 hepatitis C virus infected patients

Rates of perfect self‐reported adherence to direct‐acting antiviral therapy and its correlates among people who inject drugs on medications for opioid use disorder: The PREVAIL study

Treatment Adherence to Nucleos(t)ide Analogs in Chinese Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma: A Single-Center Cross-Sectional Study

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