Hepatitis C Patients Likely to Falter in Adherence to Treatment Regimen Over Time, Penn Study Shows

Patients being treated for chronic hepatitis C become less likely to take their medications over time, according to a new study from the Perelman School of Medicine at the University of Pennsylvania. Since the study also showed better response to the drugs when they’re taken correctly, the researchers say the findings should prompt clinicians to assess patients for barriers to medication adherence throughout their treatment, and develop strategies to help them stay on track. The study was published online in September in Annals of Internal Medicine.

“Our findings are particularly timely since many chronic hepatitis C patients are now being prescribed direct-acting antiviral drugs, which have a complex dosing regimen that may be even harder for patients to maintain than the two-drug standard therapy,” said lead author Vincent Lo Re, MD, MSCE, an assistant professor of Infectious Disease and Epidemiology

Literacy issues, financial hurdles, and socioeconomic problems such as unstable living situations can all hamper patients’ abilities to properly maintain their drug regimen. The authors suggest that refilling patients’ pill boxes for them, creating easy-to-follow dosing and refill schedules, and helping them set alarms to remind them to take their medicine may all help improve adherence.

Monitoring for and treating drug-related side effects may also be a key factor in boosting adherence, Lo Re says. The study results showed that patients who received medication for thyroid dysfunction, anemia, or low white blood cell counts – common side effects associated with hepatitis C drugs – were more likely to remain adherent to their antiviral therapy. Although those drugs added more steps into their self-care, Lo Re said the resulting relief for symptoms, including depression, fatigue and irritability, and more frequent visits to health care providers typically required with administration of these drugs, may play a role in patients’ ability to maintain the regimen overall.

“We know that a major barrier to adherence is side effects of these drugs. People don’t feel good when they’re on them,” he said. “If we can identify those problems and treat them when they occur, patients may be more motivated and feel well enough to continue with their prescribed regimen.”

Article abstract available at: http://www.annals.org/content/155/6/353.abstract

Source: University of Pennsylvania School of Medicine Press Release – September 29, 2011

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