Adherence to ribavirin in chronic hepatitis C patients on antiviral treatment: Results from a randomized controlled trial using real-time medication monitoring

L.G. van Vlerken; F.I. Lieveld; S. van Meer; G.H. Koek; K.M. van Nieuwkerk; P. Friederich; J.E. Arends; P.D. Siersema; D.M. Burger; K.J. van Erpecum

doi:10.1016/j.clinre.2015.12.014

Adherence to ribavirin in chronic hepatitis C patients on antiviral treatment: Results from a randomized controlled trial using real-time medication monitoring

L.G. van Vlerken, F.I. Lieveld, S. van Meer, G.H. Koek, K.M. van Nieuwkerk, P. Friederich, J.E. Arends, P.D. Siersema, D.M. Burger, K.J. van Erpecum^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND AND OBJECTIVE: Adherence is essential in antiviral therapy for chronic hepatitis C. We investigated the effect of real-time medication monitoring on adherence to ribavirin. METHODS: In this randomized controlled trial, patients in the intervention group received a medication dispenser that monitored ribavirin intake real-time during 24 weeks PEG-interferon/ribavirin+/-boceprevir or telaprevir. Patients in the control group received standard-of-care. Adherence was also measured by pill count. RESULTS: Seventy-two patients were assigned to either intervention (n=35) or control groups (n=37). Median adherence by pill count was 96% (range: 43%-100%) with 30 (94%) of patients exhibiting>/=80% adherence. Perfect adherence (i.e. 100%) was similar in intervention and control groups: 22 (85%) vs. 15 (75%) (P=0.47). Adherences by real-time medication monitoring and by pill count did not correlate (R=0.19, P=0.36). No predictors of poor adherence could be identified. Ribavirin trough levels after 8 weeks (median: 2.4 vs. 2.7mg/L, P=0.30) and 24 weeks (median: 3.0 vs. 3.0mg/L, P=0.69), and virological responses did not differ between intervention and control groups. CONCLUSIONS: Adherence to ribavirin during PEG-interferon containing therapy in chronic hepatitis C is high. Real-time medication monitoring did not influence adherence to ribavirin, plasma ribavirin levels or virological responses.

Original language	English
Pages (from-to)	622-630
Number of pages	9
Journal	Clinics and research in hepatology and gastroenterology
Volume	40
Issue number	5
DOIs	https://doi.org/10.1016/j.clinre.2015.12.014
Publication status	Published - Nov 2016

Keywords

SUSTAINED VIROLOGICAL RESPONSE
VIRUS-INFECTION
THERAPEUTIC STRATEGIES
PLUS RIBAVIRIN
BOCEPREVIR
TELAPREVIR
INHIBITORS
PLASMA
IMPACT

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van Vlerken, L. G., Lieveld, F. I., van Meer, S., Koek, G. H., van Nieuwkerk, K. M., Friederich, P., Arends, J. E., Siersema, P. D., Burger, D. M., & van Erpecum, K. J. (2016). Adherence to ribavirin in chronic hepatitis C patients on antiviral treatment: Results from a randomized controlled trial using real-time medication monitoring. Clinics and research in hepatology and gastroenterology, 40(5), 622-630. https://doi.org/10.1016/j.clinre.2015.12.014

@article{b09aef3b36524c609dde97a62a00e24c,

title = "Adherence to ribavirin in chronic hepatitis C patients on antiviral treatment: Results from a randomized controlled trial using real-time medication monitoring",

abstract = "BACKGROUND AND OBJECTIVE: Adherence is essential in antiviral therapy for chronic hepatitis C. We investigated the effect of real-time medication monitoring on adherence to ribavirin. METHODS: In this randomized controlled trial, patients in the intervention group received a medication dispenser that monitored ribavirin intake real-time during 24 weeks PEG-interferon/ribavirin+/-boceprevir or telaprevir. Patients in the control group received standard-of-care. Adherence was also measured by pill count. RESULTS: Seventy-two patients were assigned to either intervention (n=35) or control groups (n=37). Median adherence by pill count was 96% (range: 43%-100%) with 30 (94%) of patients exhibiting>/=80% adherence. Perfect adherence (i.e. 100%) was similar in intervention and control groups: 22 (85%) vs. 15 (75%) (P=0.47). Adherences by real-time medication monitoring and by pill count did not correlate (R=0.19, P=0.36). No predictors of poor adherence could be identified. Ribavirin trough levels after 8 weeks (median: 2.4 vs. 2.7mg/L, P=0.30) and 24 weeks (median: 3.0 vs. 3.0mg/L, P=0.69), and virological responses did not differ between intervention and control groups. CONCLUSIONS: Adherence to ribavirin during PEG-interferon containing therapy in chronic hepatitis C is high. Real-time medication monitoring did not influence adherence to ribavirin, plasma ribavirin levels or virological responses.",

keywords = "SUSTAINED VIROLOGICAL RESPONSE, VIRUS-INFECTION, THERAPEUTIC STRATEGIES, PLUS RIBAVIRIN, BOCEPREVIR, TELAPREVIR, INHIBITORS, PLASMA, IMPACT",

author = "{van Vlerken}, L.G. and F.I. Lieveld and {van Meer}, S. and G.H. Koek and {van Nieuwkerk}, K.M. and P. Friederich and J.E. Arends and P.D. Siersema and D.M. Burger and {van Erpecum}, K.J.",

year = "2016",

month = nov,

doi = "10.1016/j.clinre.2015.12.014",

language = "English",

volume = "40",

pages = "622--630",

journal = "Clinics and research in hepatology and gastroenterology",

issn = "2210-7401",

publisher = "Elsevier Masson",

number = "5",

}

van Vlerken, LG, Lieveld, FI, van Meer, S, Koek, GH, van Nieuwkerk, KM, Friederich, P, Arends, JE, Siersema, PD, Burger, DM & van Erpecum, KJ 2016, 'Adherence to ribavirin in chronic hepatitis C patients on antiviral treatment: Results from a randomized controlled trial using real-time medication monitoring', Clinics and research in hepatology and gastroenterology, vol. 40, no. 5, pp. 622-630. https://doi.org/10.1016/j.clinre.2015.12.014

Adherence to ribavirin in chronic hepatitis C patients on antiviral treatment: Results from a randomized controlled trial using real-time medication monitoring. / van Vlerken, L.G.; Lieveld, F.I.; van Meer, S. et al.
In: Clinics and research in hepatology and gastroenterology, Vol. 40, No. 5, 11.2016, p. 622-630.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Adherence to ribavirin in chronic hepatitis C patients on antiviral treatment: Results from a randomized controlled trial using real-time medication monitoring

AU - van Vlerken, L.G.

AU - Lieveld, F.I.

AU - van Meer, S.

AU - Koek, G.H.

AU - van Nieuwkerk, K.M.

AU - Friederich, P.

AU - Arends, J.E.

AU - Siersema, P.D.

AU - Burger, D.M.

AU - van Erpecum, K.J.

PY - 2016/11

Y1 - 2016/11

N2 - BACKGROUND AND OBJECTIVE: Adherence is essential in antiviral therapy for chronic hepatitis C. We investigated the effect of real-time medication monitoring on adherence to ribavirin. METHODS: In this randomized controlled trial, patients in the intervention group received a medication dispenser that monitored ribavirin intake real-time during 24 weeks PEG-interferon/ribavirin+/-boceprevir or telaprevir. Patients in the control group received standard-of-care. Adherence was also measured by pill count. RESULTS: Seventy-two patients were assigned to either intervention (n=35) or control groups (n=37). Median adherence by pill count was 96% (range: 43%-100%) with 30 (94%) of patients exhibiting>/=80% adherence. Perfect adherence (i.e. 100%) was similar in intervention and control groups: 22 (85%) vs. 15 (75%) (P=0.47). Adherences by real-time medication monitoring and by pill count did not correlate (R=0.19, P=0.36). No predictors of poor adherence could be identified. Ribavirin trough levels after 8 weeks (median: 2.4 vs. 2.7mg/L, P=0.30) and 24 weeks (median: 3.0 vs. 3.0mg/L, P=0.69), and virological responses did not differ between intervention and control groups. CONCLUSIONS: Adherence to ribavirin during PEG-interferon containing therapy in chronic hepatitis C is high. Real-time medication monitoring did not influence adherence to ribavirin, plasma ribavirin levels or virological responses.

AB - BACKGROUND AND OBJECTIVE: Adherence is essential in antiviral therapy for chronic hepatitis C. We investigated the effect of real-time medication monitoring on adherence to ribavirin. METHODS: In this randomized controlled trial, patients in the intervention group received a medication dispenser that monitored ribavirin intake real-time during 24 weeks PEG-interferon/ribavirin+/-boceprevir or telaprevir. Patients in the control group received standard-of-care. Adherence was also measured by pill count. RESULTS: Seventy-two patients were assigned to either intervention (n=35) or control groups (n=37). Median adherence by pill count was 96% (range: 43%-100%) with 30 (94%) of patients exhibiting>/=80% adherence. Perfect adherence (i.e. 100%) was similar in intervention and control groups: 22 (85%) vs. 15 (75%) (P=0.47). Adherences by real-time medication monitoring and by pill count did not correlate (R=0.19, P=0.36). No predictors of poor adherence could be identified. Ribavirin trough levels after 8 weeks (median: 2.4 vs. 2.7mg/L, P=0.30) and 24 weeks (median: 3.0 vs. 3.0mg/L, P=0.69), and virological responses did not differ between intervention and control groups. CONCLUSIONS: Adherence to ribavirin during PEG-interferon containing therapy in chronic hepatitis C is high. Real-time medication monitoring did not influence adherence to ribavirin, plasma ribavirin levels or virological responses.

KW - SUSTAINED VIROLOGICAL RESPONSE

KW - VIRUS-INFECTION

KW - THERAPEUTIC STRATEGIES

KW - PLUS RIBAVIRIN

KW - BOCEPREVIR

KW - TELAPREVIR

KW - INHIBITORS

KW - PLASMA

KW - IMPACT

U2 - 10.1016/j.clinre.2015.12.014

DO - 10.1016/j.clinre.2015.12.014

M3 - Article

C2 - 26867863

SN - 2210-7401

VL - 40

SP - 622

EP - 630

JO - Clinics and research in hepatology and gastroenterology

JF - Clinics and research in hepatology and gastroenterology

IS - 5

ER -

Adherence to ribavirin in chronic hepatitis C patients on antiviral treatment: Results from a randomized controlled trial using real-time medication monitoring

Abstract

Keywords

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