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Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
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Digestive Diseases and Sciences
Published in: Digestive Diseases and Sciences 6/2012

01-06-2012 | Review

Tangible Resources for Preparing Patients for Antiviral Therapy for Chronic Hepatitis C

Authors: Jason E. Bonner, A. Sidney Barritt IV, Michael W. Fried, Donna M. Evon

Published in: Digestive Diseases and Sciences | Issue 6/2012

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Abstract

Background

Chronic hepatitis C (HCV) infected patients with coexisting mental health and/or substance abuse issues face significant barriers to treatment and are often deferred. This paper sought to highlight critical pre-treatment strategies and provide tangible resources for HCV clinicians to facilitate preparation and successful treatment of these patients.

Methods

Guided by the clinical experience of our liver center, a large, tertiary academic medical center, and informed by the extant literature, we summarize pre-treatment strategies and specific resources and recommendations for HCV providers.

Results

Four key pre-treatment strategies include: 1) screening for mental health/substance abuse issues using brief, reliable and validated instruments; 2) locating and establishing collaborative care with mental health and substance abuse specialists; 3) using a motivational interviewing communication style; and 4) addressing adherence-related issues.

Conclusions

HCV clinicians are in a unique position to prepare patients with coexisting mental health and/or substance abuse issues for antiviral therapy.
Literature
1.
2.
3.
Volk ML. Antiviral therapy for hepatitis C: why are so few patients being treated? J Antimicrob Chemother. 2010;65:1327–1329.PubMedCrossRef
4.
Volk ML, Tocco R, Saini S, et al. Public health impact of antiviral therapy for hepatitis C in the United States. Hepatology. 2009;50:1750–1755.PubMedCrossRef
5.
Davis GL, Alter MJ, El-Serag H, et al. Aging of hepatitis C virus (HCV)-infected persons in the United States: a multiple cohort model of HCV prevalence and disease progression. Gastroenterology. 2010;138:513–521.PubMedCrossRef
6.
Kramer JR, Kanwal F, Richardson P, et al. Importance of patient, provider, and facility predictors of hepatitis C virus treatment in veterans: a national study. Am J Gastroenterol. 2011;106:483–491.PubMedCrossRef
7.
Kanwal F, Hoang T, Spiegel BM, et al. Predictors of treatment in patients with chronic hepatitis C infection—role of patient versus nonpatient factors. Hepatology. 2007;46:1741–1749.PubMedCrossRef
8.
Stepanova M, Kanwal F, El-Serag HB, et al. Insurance status and treatment candidacy of hepatitis C patients: analysis of population-based data from the United States. Hepatology. 2011;53:737–745.PubMedCrossRef
9.
Evon DM, Verma A, Dougherty KA, et al. High deferral rates and poorer treatment outcomes for HCV patients with psychiatric and substance use comorbidities. Dig Dis Sci. 2007;52:3251–3258.PubMedCrossRef
10.
Muir AJ, Provenzale D. A descriptive evaluation of eligibility for therapy among veterans with chronic hepatitis C virus infection. J Clin Gastroenterol. 2002;34:268–271.PubMedCrossRef
11.
Falck-Ytter Y, Kale H, Mullen KD, et al. Surprisingly small effect of antiviral treatment in patients with hepatitis C. Ann Intern Med. 2002;136:288–292.PubMed
12.
Butt AA, Wagener M, Shakil AO, et al. Reasons for non-treatment of hepatitis C in veterans in care. J Viral Hepat. 2005;12:81–85.PubMedCrossRef
13.
Schaefer M, Schmidt F, Folwaczny C, et al. Adherence and mental side effects during hepatitis C treatment with interferon alfa and ribavirin in psychiatric risk groups. Hepatology. 2003;37:443–451.PubMedCrossRef
14.
Schaefer M, Heinz A, Backmund M. Treatment of chronic hepatitis C in patients with drug dependence: time to change the rules? Addiction. 2004;99:1167–1175.PubMedCrossRef
15.
Schaefer M, Schwaiger M, Garkisch AS, et al. Prevention of interferon-alpha associated depression in psychiatric risk patients with chronic hepatitis C. J Hepatol. 2005;42:793–798.PubMedCrossRef
16.
Schaefer M, Hinzpeter A, Mohmand A, et al. Hepatitis C treatment in “difficult-to-treat” psychiatric patients with pegylated interferon-alpha and ribavirin: response and psychiatric side effects. Hepatology. 2007;46:991–998.PubMedCrossRef
17.
Grebely J, Genoway K, Khara M, et al. Treatment uptake and outcomes among current and former injection drug users receiving directly observed therapy within a multidisciplinary group model for the treatment of hepatitis C virus infection. Int J Drug Policy. 2007;18:437–443.PubMedCrossRef
18.
Knott A, Dieperink E, Willenbring ML, et al. Integrated psychiatric/medical care in a chronic hepatitis C clinic: effect on antiviral treatment evaluation and outcomes. Am J Gastroenterol. 2006;101:2254–2262.PubMedCrossRef
19.
Sylvestre DL, Loftis JM, Hauser P, et al. Co-occurring Hepatitis C, substance use, and psychiatric illness: treatment issues and developing integrated models of care. J Urban Health. 2004;81:719–734.PubMedCrossRef
20.
Sylvestre DL. Treating hepatitis C virus infection in active substance users. Clin Infect Dis. 2005;40:S321–S324.PubMedCrossRef
21.
Sylvestre DL, Clements BJ. Adherence to hepatitis C treatment in recovering heroin users maintained on methadone. Eur J Gastroenterol Hepatol. 2007;19:741–747.PubMedCrossRef
22.
Matthews G, Kronborg IJ, Dore GJ. Treatment for hepatitis C virus infection among current injection drug users in Australia. Clin Infect Dis. 2005;40:S325–S329.PubMedCrossRef
23.
Freedman K, Nathanson J. Interferon-based hepatitis C treatment in patients with pre-existing severe mental illness and substance use disorders. Expert Rev Anti Infect Ther. 2009;7:363–376.PubMedCrossRef
24.
Zanini B, Covolo L, Donato F, et al. Effectiveness and tolerability of combination treatment of chronic hepatitis C in illicit drug users: meta-analysis of prospective studies. Clin Ther. 2010;32:2139–2159.PubMedCrossRef
25.
Bruggmann P, Falcato L, Dober S, et al. Active intravenous drug use during chronic hepatitis C therapy does not reduce sustained virological response rates in adherent patients. J Viral Hepat. 2008;15:747–752.PubMedCrossRef
26.
Bruggmann P, Dampz M, Gerlach T, et al. Treatment outcome in relation to alcohol consumption during hepatitis C therapy: an analysis of the Swiss Hepatitis C Cohort study. Drug Alcohol Depend. 2010;110:167–171.PubMedCrossRef
27.
Evon DM, Esserman DA, Rao T, et al. Patient missed doses and treatment non-persistence during PEG/Ribavirin therapy for chronic hepatitis C: implications for triple therapy and beyond. Hepatology. 2011;54:869A.
28.
Leutscher PD, Lagging M, Buhl MR, et al. Evaluation of depression as a risk factor for treatment failure in chronic hepatitis C. Hepatology. 2010;52:430–435.PubMedCrossRef
29.
Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Measurement. 1977;1:385–401.CrossRef
30.
Evon DM, Ramcharran D, Belle SH, et al. Prospective analysis of depression during peginterferon and ribavirin therapy of chronic hepatitis C: results of the VIRAHEP-C study. American Journal of Gastroenterology. 2009;104:2949–2958.PubMedCrossRef
31.
Beck AT, Steer RA, Ball R, et al. Comparison of beck depression inventories -IA and -II in psychiatric outpatients. J Pers Assess. 1996;67:588–597.PubMedCrossRef
32.
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–613.PubMedCrossRef
33.
Hirschfeld RM, Williams JB, Spitzer RL, et al. Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire. Am J Psychiatry. 2000;157:1873–1875.PubMedCrossRef
34.
Nassir GS, Miller CJ, Berv DA, et al. Sensitivity and specificity of a new bipolar spectrum diagnostic scale. J Affect Disord. 2005;84:273–277.CrossRef
35.
Saunders JB, Aasland OG, Babor TF, et al. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction. 1993;88:791–804.PubMedCrossRef
36.
Yudko E, Lozhkina O, Fouts A. A comprehensive review of the psychometric properties of the Drug Abuse Screening Test. J Subst Abuse Treat. 2007;32:189–198.PubMedCrossRef
37.
Sylvestre D. Hepatitis C treatment in drug users: perception versus evidence. Eur J Gastroenterol Hepatol. 2006;18:129–130.PubMedCrossRef
38.
Rollnick S, Miller W, Butler C. Motivational Interviewing in Health Care: Helping Patients Change Behavior. New York: The Guilford Press; 2007.
39.
Emmons KM, Rollnick S. Motivational interviewing in health care settings. Opportunities and limitations. Am J Prev Med. 2001;20:68–74.PubMedCrossRef
40.
Miller WR, Rollnick S. Motivational interviewing: preparing people for change. New York: Guilford Press; 2002.
41.
Martins RK, McNeil DW. Review of motivational interviewing in promoting health behaviors. Clin Psychol Rev. 2009;29:283–293.PubMedCrossRef
42.
Knight KM, McGowan L, Dickens C, et al. A systematic review of motivational interviewing in physical health care settings. Br J Health Psychol. 2006;11:319–332.PubMedCrossRef
43.
Searight HR. Efficient counseling techniques for the primary care physician. Prim Care. 2007;34:551–570.PubMedCrossRef
44.
Lev-Ran S, Nitzan U. Motivational interviewing in health care. Harefuah. 2011;150:749.
45.
Callahan EJ, Flynn NM, Kuenneth CA, et al. Strategies to reduce HIV risk behavior in HIV primary care clinics: brief provider messages and specialist intervention. AIDS Behav. 2007;11:S48–S57.PubMedCrossRef
46.
Rubak S, Sandbaek A, Lauritzen T, et al. Motivational interviewing: a systematic review and meta-analysis. Br J Gen Pract. 2005;55:305–312.PubMed
47.
Miller WR. Enhancing motivation for change in substance abuse treatment. Treatment improvement protocol (TIP) series 35. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment. DHHD Publication No. (SMA) 99-3354. Rockville, MD; 1999.
48.
Rifai MA, Moles JK, Lehman LP, et al. Hepatitis C screening and treatment outcomes in patients with substance use/dependence disorders. Psychosomatics. 2006;47:112–121.PubMedCrossRef
49.
Dieperink E, Ho SB, Heit S, et al. Significant reductions in drinking following brief alcohol treatment provided in a hepatitis C clinic. Psychosomatics. 2010;51:149–156.PubMed
50.
Berg CJ, Michelson SE, Safren SA. Behavioral aspects of HIV care: adherence, depression, substance use, and HIV-transmission behaviors. Infect Dis Clin North Am. 2007;21:181–200.PubMedCrossRef
51.
Golin C, Isasi F, Bontempi JB, et al. Secret pills: HIV-positive patients’ experiences taking antiretroviral therapy in North Carolina. AIDS Educ Prev. 2002;14:318–329.PubMedCrossRef
52.
Haynes RB, Ackloo E, Sahota N, et al. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2008;CD000011.
53.
Hendershot CS, Stoner SA, Pantalone DW, et al. Alcohol use and antiretroviral adherence: review and meta-analysis. J Acquir Immune Defic Syndr. 2009;52:180–202.PubMedCrossRef
54.
McHutchison JG, Manns M, Patel K, et al. Adherence to combination therapy enhances sustained response in genotype-1-infected patients with chronic hepatitis C. Gastroenterology. 2002;123:1061–1069.PubMedCrossRef
55.
Martin-Santos R, Diez-Quevedo C, Castellvi P, et al. De novo depression and anxiety disorders and influence on adherence during peginterferon-alpha-2a and ribavirin treatment in patients with hepatitis C. Aliment Pharmacol Ther. 2008;27:257–265.PubMedCrossRef
56.
Paterson DL, Swindells S, Mohr J, et al. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000;133:21–30.PubMed
57.
58.
Hill S, Kavookjian J. Motivational interviewing as a behavioral intervention to increase HAART adherence in patients who are HIV-positive: a systematic review of the literature. AIDS Care. (Epub ahead of print). doi:10.​1080/​09540121.​2011.​630354.
59.
Zolnierek KB, Dimatteo MR. Physician communication and patient adherence to treatment: a meta-analysis. Med Care. 2009;47:826–834.PubMedCrossRef
60.
Martin LR, Williams SL, Haskard KB, et al. The challenge of patient adherence. Ther Clin Risk Manag. 2005;1:189–199.PubMed
61.
Tanioka D, Iwasaki Y, Araki Y, et al. Factors associated with adherence to combination therapy of interferon and ribavirin for patients with chronic hepatitis C: importance of patient’s motivation and physician’s treatment experience. Liver Int. 2009;29:721–729.PubMedCrossRef
62.
Simoni JM, Amico KR, Pearson CR, et al. Strategies for promoting adherence to antiretroviral therapy: a review of the literature. Curr Infect Dis Rep. 2008;10:515–521.PubMedCrossRef
63.
Golin CE, Liu H, Hays RD, et al. A prospective study of predictors of adherence to combination antiretroviral medication. J Gen Intern Med. 2002;17:756–765.PubMedCrossRef
64.
Vezali E, Aghemo A, Colombo M. Interferon in the treatment of chronic hepatitis C: a drug caught between past and future. Expert Opin Biol Ther. 2011;11:301–313.PubMedCrossRef
65.
Kanwal F, Hoang T, Kramer JR, et al. Increasing prevalence of HCC and cirrhosis in patients with chronic hepatitis C virus infection. Gastroenterology. 2011;140:1182–1188.PubMedCrossRef
Metadata
Title
Tangible Resources for Preparing Patients for Antiviral Therapy for Chronic Hepatitis C
Authors
Jason E. Bonner
A. Sidney Barritt IV
Michael W. Fried
Donna M. Evon
Publication date
01-06-2012
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 6/2012
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-012-2142-3

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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

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