Telemedicine Chronic Viral Hepatitis C Treatment during the Lockdown Period in Romania: A Pilot Study

Abstract

The COVID-19 pandemic is currently delaying the process of chronic hepatitis C (HCV) eradication, since most of the chronic diseases are neglected. Thus, there is a need for alternative programs for HCV therapy implementation and disease monitoring. Our aim was to provide a multidisciplinary approach, so that HCV-infected patients from distant locations may benefit from HCV antivirals during the COVID-19 outbreak and within the lockdown period in Romania. Previously diagnosed HCV patients willing to participate in this telemedicine pilot study were included. Patient characteristics and medical adherence were assessed and compared to the year preceding the pandemic. We proposed a multidisciplinary approach by using a telemedicine program for HCV therapy monitoring. Patients also received a satisfaction questionnaire after delivering the sustained virologic response (SVR) result. A total of 41 patients agreed to participate in this study. The medication adherence was 100% for patients included in the telemedicine group, with a statistically significant difference from the medication adherence of the patients treated in 2019. The satisfaction item score was 4.92 out of 5 and our results (r = −0.94, p < 0.0001) suggested that older patients embraced the telemedicine program less, but with the same success in terms of SVR (100%) and medication adherence (100%). Our pilot study offers the first example of a telemedicine program in Romania for HCV therapeutic management. During the lockdown period, telemedicine has served as a reliable tool and novel alternative for conventional monitoring of patients treated with direct antiviral agents and should be further considered even following the pandemic.

Telemedicine and eHealth Literacy in the Era of COVID-19: A Cross-Sectional Study in a Peripheral Clinic in Israel

“…As can be found in other studies conducted during the COVID-19 era [ 31 ], the participants understood the advantages of telemedicine, such as improving waiting time and saving time as a whole (81%), the ease of use of a telemedicine app (70%), and improved accessibility (68%). However, in contrast to the findings in previous studies that showed a high level of satisfaction with online treatment sessions [ 31 , 32 , 33 , 34 ], in the current study, only 36% expressed satisfaction about the online sessions, and only 38% of the respondents who participated in treatment sessions on the internet felt that the online visits were identical in quality to in-person visits. Less than one half of them (45%) anticipated using telemedicine after the end of the pandemic.…”

Perspectives on Telemedicine during the Era of COVID-19; What Can Saudi Arabia Do?

“…Yet, telemedicine has flourished during the same period, with many hospitals and healthcare workers resorted to online consultations to manage patients with urological [26], dermatological [27], hepatic [28], immunological [29], and endocrinal conditions [30].…”

Development and Validation of a Questionnaire to Measure Medication Adherence to Direct-Acting Agents in Patients with Hepatitis C

“…It is inexpensive and according to our results serves as a reliable method to assess HCV patient's adherence. It is noteworthy that HCV-AD may not only be used only by prescribing physicians, but also by pharmacists, since studies have shown their potential role in medication adherence [17]. Involving a multidisciplinary team could raise patients trust and understanding of DAA for HCV management.…”

“…As there is no documented standard of DAA adherence to obtain cure rates [13], a new valid and clinically useful threshold could be established for DAA non-adherence from which a patient no longer could have good outcomes in HCV treatment. Studies so far have focused on pill counts (PC) [14], the use of Visual Analog Scale (VAS) [15] and mostly pharmacy records [16,17], which help to construct a general idea in specific situations over medication adherence. The number of wireless pillbox openings or video-recorded ingestions was used for DAA adherence monitoring [18].…”