Theme: Clinical Research Year: 2016
ANALYSIS OF ADHERENCE TO ALL-ORAL HCV THERAPY IN A COHORT OF PEOPLE WHO INJECT DRUGS (PWID)
Brian Conway, Syune Hakobyan, Tyler Raycraft, Yashna, Bhutani, Arshia Alimohammadi, Rajvir Shahi, Ghazal Kiani, Sahand Vafadary
Introduction: The majority of incident and prevalent HCV infection in Canada is diagnosed among PWID. Recent access to effective and well tolerated all-oral regimens increases the likelihood of successful HCV therapy in this population. Successful treatment is dependent on adherence to the regimen as prescribed, and this has traditionally been considered a challenge in the PWID population. We hypothesize that the provision of treatment within a multidisciplinary centre attending to all health care needs will maximize the likelihood of adherence to maximize the benefits of treatment.
Method: Adherence data were generated from PWID receiving all-oral HCV treatment between 04/15-03/16 at a multidisciplinary clinic in Vancouver. In addition to HCV therapy, our centre provides services to address all medical, social and psychologic needs of the patient. HCV treatment regimens were chosen according to contemporary clinical guidelines for 12-24 weeks and adherence measured by pill count at visits every 1-4 weeks, with the frequency of follow-up visits scheduled according to patient request or clinical need. Medications were dispensed at each clinic visit, with adherence measured as a function of attendance at scheduled appointments (+/- 3 days) and pill count consistent with 90 % adherence to medication consumption as prescribed between clinic visits.
Result: Within a cohort of 87 patients (mean age 55 [34-75] years, 65% male, 29% on opioids, 18% on cocaine, 18% on stimulants, 29 % on methadone, 82% on a 12 week regimen of HCV therapy), adherence to a total of 1150 scheduled appointments was 98.7% (attendance recorded for 1135/1150 appointments, with pill counts reflecting > 90% adherence to therapy).
Conclusion: Adherence to HCV therapy among PWID treated in clinical practice appears to parallel that recorded in clinical trials conducted in such populations, such as C-EDGE CO-STAR. This information will help support expansion of HCV treatment programs in this population.Download abstract