Sunday, February 3, 2019

Interferon-free hepatitis C therapies: barriers to adherence and optimizing treatment outcomes

Research Article
Experiences with interferon-free hepatitis C therapies: addressing barriers to adherence and optimizing treatment outcomes 
Avy A. Skolnik, Amanda Noska, Vera Yakovchenko, Jack Tsai, Natalie Jones, Allen L. Gifford and D. Keith McInnes
Received: 24 August 2018
Accepted: 14 January 2019
Published: 1 February 2019

Despite medications with increased efficacy and effectiveness, and few onerous side-effects, there is much to be learned about achieving high rates of SVR while delivering positive patient treatment experiences. Newer HCV medications carry considerable financial costs, and are not without context-related adherence barriers, side effects, and potential for complex dosing. This suggest that even amidst optimism about dramatically reducing rates of HCV, patient access to medications, treatment adherence and treatment completion remain critical issues in combatting HCV.

Millions of Americans are living with hepatitis C, the leading cause of liver disease in the United States. Medication treatment can cure hepatitis C. We sought to understand factors that contribute to hepatitis C treatment completion from the perspectives of patients and providers.

We conducted semi-structured interviews at three Veterans Affairs Medical Centers. Patients were asked about their experiences with hepatitis C treatments and perspectives on care. Providers were asked about observations regarding patient responses to medications and perspectives about factors resulting in treatment completion. Transcripts were analyzed using a grounded thematic approach—an inductive analysis that lets themes emerge from the data.

Contributors to treatment completion included Experience with Older Treatments, Hope for Improvement, Symptom Relief, Tailored Organized Routines, and Positive Patient-Provider Relationship. Corresponding barriers also emerged, including pill burden and skepticism about treatment effectiveness and safety.

Despite the improved side-effect profile of newer HCV medications, multiple barriers to treatment completion remain. However, providers and patients were able to identify avenues for addressing such barriers.

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