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International Journal of Clinical Pharmacy

, Volume 41, Issue 6, pp 1545–1554 | Cite as

Measure of adherence to direct-acting antivirals as a predictor of the effectiveness of hepatitis C treatment

  • María Ángeles Campos Fernández de SevillaEmail author
  • Marta Gallego Úbeda
  • Maria Tovar Pozo
  • Emilio García-Cabrera
  • Beatriz Monje García
  • Federico Tutau Gómez
  • Laura Delgado Téllez de Cepeda
  • Irene Iglesias-Peinado
Research Article
  • 39 Downloads

Abstract

Background Adherence to direct-acting antivirals could be a predictor response to these treatments in hepatitis C. Objective To assess the ability of three methods of measuring adherence to direct-acting antivirals [pill counts, pharmacy dispensing record and Simplified Medication Adherence Questionnaire (SMAQ)] as predictors of their effectiveness. Setting Study conducted by the pharmacy department of the hospital. Methods: A retrospective study was performed. Patients ≥ 18 years with hepatitis C that started and completed treatment with direct-acting antivirals between the 1st-April-2015 and 28st-February-2016 were enrolled. To evaluate the predictive ability to obtain a response to treatment, Chi squared test, Mann–Whitney-U test and ROC-curves were used. Main outcome measure Adherence to antivirals was assessed by three methods and response to treatment, which was defined as obtaining a viral load of hepatitis C virus ≤ 15UI/ml at week 12 after the end of treatment. Results 128 patients were enrolled. The overall average adherence obtained with SMAQ (99.09%) was similar to the pill counts (96.40%, p = 0.043) and pharmacy dispensing record (91.10%, p = 0.02). There was no correlation between the percentage of patients considered as adherent by SMAQ (99.09%) and the achievement of response to treatment (96.40%, p = 0.999). The ROC-curve obtained for the pill count method shows a global area under the curve of 0.53. For pharmacy dispensing record method, patients with an adherence ≤ 66.66% have a high probability of not achieving response (sensitivity and specificity of 79.00% and 100.00%, respectively). Conclusions Pharmacy dispensing record is shown as the best indicator of adherence to predict therapeutic failure in our study.

Keywords

Adherence Antivirals Chronic hepatitis C Infectious diseases Spain 

Notes

Acknowledgements

The authors thank Javier Fernández de Sevilla for help with English language.

Funding

The authors declare that they have not received any type of financing for the realization of this study.

Conflicts of interest

All authors confirm that there are no known conflicts of interest associated with this publication.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Clinical Pharmacy, Pharmacy DepartmentHospital Universitario del HenaresCoslada, MadridSpain
  2. 2.Delos ClinicalSevilleSpain
  3. 3.PharmD and Clinical Pharmacy, Pharmacy DepartmentHospital Universitario del HenaresCoslada, MadridSpain
  4. 4.PharmD, Faculty of PharmacyUniversidad Complutense de MadridMadridSpain

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