The Hepatitis C treatment experience: Patients’ perceptions of the facilitators of and barriers to uptake, adherence and completion

Sublette, Victoria Anne; Smith, Sian K; George, Jacob; McCaffery, Kirsten; Douglas, Mark W.

doi:10.1080/08870446.2015.1012195

Cited by 45 publications

(51 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Obtaining information during treatment on the likelihood of treatment success through viral load testing was identified in one study as an adherence motivator 44. While experience of hepatitis C-related stigma, often related to a history of injecting drug use, was also associated with medication adherence 42,45. Sublette et al42 found that participants reported feeling “unclean” and “embarrassed about divulging their status to doctors and dentists”, but this stigma disappeared once they had been cured of hepatitis C 42.…”

Section: Assessing and Supporting Patient Adherence With Daasmentioning

confidence: 99%

“…While experience of hepatitis C-related stigma, often related to a history of injecting drug use, was also associated with medication adherence 42,45. Sublette et al42 found that participants reported feeling “unclean” and “embarrassed about divulging their status to doctors and dentists”, but this stigma disappeared once they had been cured of hepatitis C 42. The pervasive and negative impact of hepatitis C-related stigma on treatment adherence has highlighted the importance of the patient–health professional relationship, in terms of ameliorating the effects of stigma and building trust, which can improve adherence to care 46…”

Section: Assessing and Supporting Patient Adherence With Daasmentioning

confidence: 99%

“…Commitment of patients to nurse or clinician who treats hepatitis C virus infection is regularly identified as a strong facilitator of medication adherence, particularly in the setting of a collaborative relationship and open communication, which lead to honest dialogue about challenges to adherence 40,42. In addition, social and emotional support provided by family and friends is critical to facilitating medication adherence, particularly in the setting of adverse treatment side effects.…”

Section: Assessing and Supporting Patient Adherence With Daasmentioning

confidence: 99%

“…While there is an expectation of improved adherence to the simplified DAA regimens, DAAs are now being prescribed to patients who would not have previously been offered PEG-IFN-based regimens, with reduced monitoring and interaction with health professionals 42. Patient-related factors including forgetfulness, busy daily schedules and responsibility to family and friends, mental health issues, stigma, and low heath literacy will remain significant considerations when assessing the likelihood of patient adherence 48,49.…”

Section: Assessing and Supporting Patient Adherence With Daasmentioning

confidence: 99%

“…Pretreatment education should include consideration of the following topics: Hepatitis C disease and disease progressionThe need for DAA treatmentHow the DAAs work and possible side effectsRelevant monitoring and surveillance testing during and after treatment completionOverview of medication adherence and importance of adherence to the DAAsPotential for drug–drug interactions, decreased efficacy of DAAs, and increased adverse effects due to prescribed and nonprescribed medicationsStrategies to support adherenceImportance of discussing potential and actual adherence problems and the importance of completing the course of DAA treatment with a health professional and seeking adherence guidance promptly51Harm minimization strategies to prevent and reduce hepatitis C reinfection through injecting drug use, intranasal drug use, unsafe sexual practices, and cultural practicesDisclosure and privacy issues related to hepatitis C and DAA administration; the impact of hepatitis C-related stigma and discrimination on DAA adherence 42…”

Section: Assessing and Supporting Patient Adherence With Daasmentioning

confidence: 99%

See 4 more Smart Citations

The Australasian Hepatology Association consensus guidelines for the provision of adherence support to patients with hepatitis C on direct acting antivirals

Richmond¹,

Sheppard‐Law²,

Mason³

et al. 2016

PPA

View full text Add to dashboard Cite

BackgroundHepatitis C is a blood-borne virus primarily spread through sharing of drug-injecting equipment. Approximately 150 million people worldwide and 230,000 Australians are living with chronic hepatitis C infection. In March 2016, the Australian government began subsidizing direct acting antivirals (DAAs) for the treatment of hepatitis C, which are highly effective (95% cure rate) and have few side effects. However, there is limited evidence to inform the provision of adherence support to people with hepatitis C on DAAs including the level of medication adherence required to achieve a cure.MethodologyIn February 2016, a steering committee comprising four authors convened an expert panel consisting of six hepatology nurses, a hepatologist, a pharmacist, a consumer with hepatitis C and treatment experience, and a consumer advocate. The expert panel focused on the following criteria: barriers and enablers to DAA adherence; assessment and monitoring of DAA adherence; components of a patient-centered approach to DAA adherence; patients that may require additional adherence support; and interventions to support DAA adherence. The resultant guidelines underwent three rounds of consultation with the expert panel, Australasian Hepatology Association (AHA) members (n=12), and key stakeholders (n=7) in June 2016. Feedback was considered by the steering committee and incorporated if consensus was achieved.ResultsTwenty-four guidelines emerged from the evidence synthesis and expert panel discussion. The guidelines focus on the pretreatment assessment and education, assessment of treatment readiness, and monitoring of medication adherence. The guidelines are embedded in a patient-centered approach which highlights that all patients are at risk of nonadherence. The guidelines recommend implementing interventions focused on identifying patients’ memory triggers and hooks; use of nonconfrontational and nonjudgmental language by health professionals; and objectively monitoring adherence.ConclusionThese are the first guidelines to support patients and health professionals in the delivery of clinical care by identifying practical adherence support interventions for patients taking DAAs.

show abstract

Section: Assessing and Supporting Patient Adherence With Daasmentioning

confidence: 99%

Section: Assessing and Supporting Patient Adherence With Daasmentioning

confidence: 99%

Section: Assessing and Supporting Patient Adherence With Daasmentioning

confidence: 99%

Section: Assessing and Supporting Patient Adherence With Daasmentioning

confidence: 99%

Section: Assessing and Supporting Patient Adherence With Daasmentioning

confidence: 99%

See 3 more Smart Citations

The Australasian Hepatology Association consensus guidelines for the provision of adherence support to patients with hepatitis C on direct acting antivirals

Richmond¹,

Sheppard‐Law²,

Mason³

et al. 2016

PPA

View full text Add to dashboard Cite

show abstract

Accessible Hepatitis C Care for People Who Inject Drugs

et al. 2022

View full text Add to dashboard Cite

IMPORTANCETo achieve hepatitis C elimination, treatment programs need to engage, treat, and cure people who inject drugs.OBJECTIVE To compare a low-threshold, nonstigmatizing hepatitis C treatment program that was colocated at a syringe service program (accessible care) with facilitated referral to local clinicians through a patient navigation program (usual care). DESIGN, SETTING, AND PARTICIPANTSThis single-site randomized clinical trial was conducted at the Lower East Side Harm Reduction Center, a syringe service program in New York, New York, and included 167 participants who were hepatitis C virus RNA-positive and had injected drugs during the prior 90 days. Participants enrolled between July 2017 and March 2020. Data were analyzed after all patients completed 1 year of follow-up (after March 2021).INTERVENTIONS Participants were randomized 1:1 to the accessible care or usual care arm. MAIN OUTCOMES AND MEASURESThe primary end point was achieving sustained virologic response within 12 months of enrollment. RESULTS Among the 572 participants screened, 167 (mean [SD] age, 42.0 [10.6] years; 128 (77.6%) male, 36 (21.8%) female, and 1 (0.6) transgender individuals; 8 (4.8%) Black, 97 (58.5%) Hispanic, and 53 (32.1%) White individuals) met eligibility criteria and were enrolled, with 2 excluded postrandomization (n = 165). Baseline characteristics were similar between the 2 arms. In the intention-to-treat analysis, 55 of 82 participants (67.1%) in the accessible care arm and 19 of 83 participants (22.9%) in the usual care arm achieved a sustained virologic response (P < .001). Loss to follow-up (12.2% [accessible care] and 16.9% [usual care]; P = .51) was similar in the 2 arms. Of the participants who received therapy, 55 of 64 (85.9%) and 19 of 22 (86.3%) achieved a sustained virologic response in the accessible care and usual care arms, respectively (P = .96). Significantly more participants in the accessible care arm achieved all steps in the care cascade, with the greatest attrition in the usual care arm seen in referral to hepatitis C virus clinician and attending clinical visit. CONCLUSIONS AND RELEVANCEIn this randomized clinical trial, among people who inject drugs with hepatitis C infection, significantly higher rates of cure were achieved using the accessible care model that focused on low-threshold, colocated, destigmatized, and flexible hepatitis C care compared with facilitated referral. To achieve hepatitis C elimination, expansion of treatment programs that are specifically geared toward engaging people who inject drugs is paramount.

show abstract

The challenges of hepatitis C management in Iran: A qualitative study with patients

Behzadifar

Azari

Gorji

et al. 2019

Health Planning & Management

View full text Add to dashboard Cite

Background: The patient's perspective concerning the treatment process and the knowledge of the challenges and problems that they encounter can help to improve their treatment conditions. Aim: The present study aimed at analyzing the experiences of hepatitis C virus (HCV) patients in Iran and the challenges encountered during the management and treatment process. Methods: Semi-structured in-depth and face-to-face interviews were conducted. The criteria for selecting patients were as follows: HCV-positive subjects, with confirmed diagnosis of HCV, and under treatment. Content analysis was used to analyze the data. MAXQDA Ver11 software was used to better manage data. This study is based on the "Consolidated Criteria for Reporting Qualitative Research" (COREQ) checklist.Results: Twenty-one HCV patients were interviewed. The mean age of participants was 36.14 ± 11.29 years. Seven themes with 20 subthemes emerged from the content analysis of the interviews, namely, (a) disease-related stigma, (b) lack of knowledge, (c) psychological problems, (d) financial problems, (e) complications of treatment, (f) lack of family and community support, and (g) health-care system. Conclusion:The findings of this study showed that a range of economic, social, and cultural problems could affect the treatment of HCV patients. Health policy and decision

show abstract

The Hepatitis C treatment experience: Patients’ perceptions of the facilitators of and barriers to uptake, adherence and completion

Abstract: To increase treatment adherence and completion rates, a patient-centred approach is required that addresses patients' social, practical, and emotional support needs and adaptive coping strategies.

Cited by 45 publications

References 50 publications

The Australasian Hepatology Association consensus guidelines for the provision of adherence support to patients with hepatitis C on direct acting antivirals

The Australasian Hepatology Association consensus guidelines for the provision of adherence support to patients with hepatitis C on direct acting antivirals

Accessible Hepatitis C Care for People Who Inject Drugs

The challenges of hepatitis C management in Iran: A qualitative study with patients

Contact Info

Product

Resources

About