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Impact of pill burden on adherence to hepatitis C medication

Jaejin An1, Janet S Lee2, Lucie Sharpsten3

  • 1Western University of Health Sciences , Pomona , CA , USA.

Current Medical Research and Opinion
|July 13, 2019
PubMed

Insights

Patients with hepatitis C virus (HCV) experience a high pill burden, which increases with more daily medications. Higher HCV pill burden is linked to greater gaps in HCV therapy, impacting treatment adherence.

Area of Science:

  • Hepatology and Infectious Diseases
  • Pharmacoeconomics and Health Outcomes Research

Background:

  • Patients with hepatitis C virus (HCV) often manage multiple medications, leading to a significant pill burden.
  • Understanding this pill burden is crucial for optimizing treatment adherence and outcomes in HCV management.

Purpose of the Study:

  • To quantify the pill burden in patients before and after initiating direct-acting antiviral (DAA) therapy for HCV.
  • To investigate the association between HCV pill burden and treatment adherence, specifically gaps in therapy.

Main Methods:

  • Retrospective analysis of administrative claims data for 9815 patients treated with DAAs for HCV between November 2013 and July 2016.
  • Pill burden calculated daily for HCV and non-HCV medications; gaps in HCV therapy assessed post-initiation.
  • Multivariable logistic regression analyzed the odds of therapy gaps across different HCV pill burden categories (1, 2, or ≥3 pills/day).

Main Results:

  • Mean overall pill burden increased from 5.4 before DAA initiation to 7.7 after (p < .001).
  • Patients taking 2 HCV pills/day had 1.75 times higher odds of a ≥15-day therapy gap; those taking ≥3 pills/day had 2.11 times higher odds, compared to 1 pill/day.
  • Higher HCV pill burden was significantly associated with increased gaps in HCV therapy.

Conclusions:

  • HCV patients face a substantial pill burden even prior to starting treatment.
  • Increased HCV pill burden is directly associated with lower medication adherence and greater therapy gaps.
  • Pill burden is a critical factor to consider when selecting HCV treatment regimens to improve adherence.

Keywords:
Antiviral agentshepatitis C, chronicmedication adherenceretrospective studies

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