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The Evaluation of Medication Adherence in Patients Infected With HCV Receiving Protease Inhibitors: A Pilot Study
Suzana Muller1, Aline Patricia Brietzke, Deivid Cruz Dos Santos
1Suzana Muller, PhD, RN, Department of Clinical Research Center, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. Aline Patricia Brietzke, MSc, RN, Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. Deivid Cruz dos Santos, Department of Internal Medicine (Gastroenterology/Hepatology), Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; and Ramiro Barcelos 2350, Bairro Rio Branco, Porto Alegre, RS, Brazil. Michelle Moraes Jacinto, Department of Clinical Research Center, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. Matheus Truccolo Michalczuk, MD, Department of Internal Medicine (Gastroenterology/Hepatology), Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; and Ramiro Barcelos 2350, Bairro Rio Branco, Porto Alegre, RS, Brazil. Mário Reis Álvarez-da-Silva, MD, PhD, Department of Internal Medicine (Gastroenterology/Hepatology), Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; and Ramiro Barcelos 2350, Bairro Rio Branco, Porto Alegre, RS, Brazil.
Abstract:
Adherence to treatment is essential for hepatitis C cure. Studies show the complexity of the treatment due to side effects, many pills, and rigor in the schedules. The aim of this study was to evaluate the adherence to treatment with protease inhibitor in patients with hepatitis C. It is a longitudinal, observational, prospective pilot study with patients with hepatitis C genotype 1. Bimonthly consultations and biweekly calls for 20 weeks were performed. Evaluation methods for adherence were Measure of Adherence to Treatment score, patient report, count pills, and sustained virological response. Twenty-two patients were enrolled. Mean age was 54.0 ± 8.72 years; 50% were men, educational level was 7.9 ± 3.89 years for the study, and intake of pills was 2.2 ± 1.60 per day. Adverse events reported were fatigue (90.9%), muscular pain (72.7%), and nausea (68.2%). In total, 71.4% of patients took 100% of medications and were classified as having a high degree of adherence to treatment. The sustained virological response was not significant in relation to the high or low adherence degree. Measure of Adherence to Treatment score is a good instrument to measure adherence to protease inhibitor treatment. The adherence of patients undergoing long-term and complex treatments improves when the multidisciplinary team follows up every 7-15 days. The patient's access to the team through additional phone calls or medical/nursing appointment is essential to improve adherence.
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