Tag Archives: adherence

A patient’s journey through their hepatitis C treatment and care.

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This article is a guest post by David Rowlands, see toward the bottom for contact details.

Insight 7: “Motivation is key”
(Treatment Week 4 of 12)

When I first started treatment I had a number of blood tests, one measuring the “viral load” which showed the amount of hepatitis C present within my blood. At this time my viral load was showing to be 44,270,000, for me this was a very high result and I felt anxious about my next blood tests which were 2 weeks into my treatment. I have now received these blood results and I have had a huge reduction in my viral load. This is fantastic news and now is showing at 452.

Feeling Anxious

I felt anxious about having my blood tests, this is totally normal. I find speaking to a close friend or family before or after getting results does help and you as you are able to air any concerns you maybe having.

Feeling motivated

Receiving these results has motivated me. I am taking the correct prescribed medication at the correct times and these results are showing this. These results are helping me to stay on track of my treatment.

Not every patents viral load drops so quickly. I would contact you healthcare team or AbbVie Care, if you do have any treatment concerns. They may be able to help and support you to make the changes needed, I am sure you will want to achieve the best outcomes from your hepatitis C therapy and making small amends to when or how you take your treatment could be an option.

What motivates me to stay on track?

  • I have high chance of curing my hepatitis C.
  • I feel better now, than in a long time.
  • I might stop feeling so exhausted after clearing my hepatitis C.
    Already I have got rid of the brain fog I was experiencing.
  • I can improve my liver health.
  • I can drink alcohol again when I have completed treatment.
  • I won’t need to worry about passing hepatitis C onto someone else.
  • I won’t have to worry about how to tell people I have hepatitis C anymore.
  • I can live free from fear of serious liver disease or liver cancer in the future.

Motivational messages to help you stay on track

The AbbVie Care patient support programme offers motivational messages throughout your treatment. The programme tailors the support a patients gets using patient activation measure (PAM) score. This score (low, medium and high) will determine the number of messages you receive through your treatment.

Here are some examples you may receive

Week 2 (High and medium PAM score)
“Hello from AbbVie Care. Well done on getting through your first week and welcome to AbbVie Care. We are here to support you if you need us in addition to your specialist team. Call us on 0800 1488322”

Week 3 (Low PAM score)
”Hello from AbbVie Care. Try to keep a positive frame of mind. Think about something that makes you smile or link up with someone who can support you if you are struggling”

Week 4 (Low PAM score)
“Hello from AbbVie Care. Well done on getting to 4 weeks, you’re doing really well. Only 8 weeks left to go till you complete treatment. Remember every single dose counts for the best chance of a good result”

Try something new

It’s the last thing you want to be doing when you don’t feel one hundred percent, but I have found trying something new has given me more energy. Running, walking, and cycling has given me fresh air, even if it has been for a few minutes.

I feel it has improved my moods, stress, and physical health, but also made me sleep better in the evenings. If you don’t feel like you have so much energy, read a new book or learn a news skill, use this treatment experience to do something new, explore something you have always wanted to.

New week…..

My insight will be focusing on “side-effects” I believe this is an important topic to discuss to look at what minimal side-effects I am experiencing and how I addressing these.

About the author:

David Rowlands is the director of Design-Redefined.co.uk, delivering effective healthcare communications to enable people with HIV and/or hepatitis C (HCV) to become better engaged with their treatment and care.

Drawing on his established networks and collaboration with partners, David is able to bring healthcare together, by engaging patients & organisations, healthcare providers, physicians, stakeholders & policy makers.

Contact David via Email, Twitter, or visit his website.

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Don’t Stop Taking Meds If And When You Drink!

About half of HIV patients on antiretroviral therapy skipped their medications whenever they were drinking alcohol, according to a U.S. study – an ill-advised behavior that researchers say could lead to higher viral loads.

The study, published in the Journal of General Internal Medicine, for a year followed nearly 200 people with HIV who were on antiretrovirals and drank alcohol. It found that 51 percent stopped taking their medications while drinking.

Lapses could be due to forgetfulness while under the influence, but a widespread – and erroneous – belief that mixing alcohol and HIV drugs can be toxic appears to play a role.

“The harms caused by missing their medications far outweigh the harms caused by mixing the two, if the person doesn’t have liver disease,” said Seth Kalichman, a professor at the University of Connecticut and lead author of the study.

Drinking has been known to interfere with people’s adherence to their medications, but researchers said the consequences of inconsistent use of HIV medications can be more severe.

Antiretroviral drugs suppress the HIV virus, and patients must take the medications continuously to prevent the virus from surging. Additionally, going on and off the drugs can lead to drug resistance.

“People living with HIV who deliberately stop their medications when they are drinking are at risk for treatment failure,” the researchers wrote.

Kalichman and his colleagues surveyed 178 people – about four out of five of them men – who were currently using antiretroviral therapy and reported that they drank alcohol.

At the beginning of the study, the researchers asked the participants about their alcohol-related beliefs, such as whether they thought their drugs wouldn’t work as well if the two mixed. They also asked whether people would not take both at the same time, either by avoiding alcohol or the medicines.

Over the following year, the team checked in with patients every month to see how well they were sticking to their prescriptions through a pill count, and every other month they called to ask how often the patient had been drinking recently.

Doctors’ offices measured each patient’s level of virus and measures of immune system health.

They found that 51 percent of the patients would avoid the medications when they drank, and half of the people in this group had poor adherence to their prescriptions. In addition, half of the group that skipped pills said they wouldn’t take them again until the alcohol was out of their system.

People who skipped medications while drinking were also more likely to have higher levels of HIV in their bodies and lower numbers of CD4 cells, a measure of immune system health.

“I think it’s pretty well demonstrated that alcohol use is tied to poor adherence, and I think most people think it’s because they’re impaired in some way or they forget… whereas here it shows they’re (often) intentionally missing their medications,” said Catherine Grodensky, a researcher at the Center for AIDS Research at the University of North Carolina.

“And it looks like it’s having some significant impacts on their treatment.”

Original Article via Reuters

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Pill Box Organisers Increase HIV Patients’ Adherence & Improve Viral Suppression

Inexpensive pill box organisers are an easy, successful, and cost-effective tool to help patients take their medications as prescribed, according to a study of low-income urban residents living with HIV infection.

“Clinicians and pharmacists can meaningfully improve treatment outcomes with simple and inexpensive strategies, such as pill box organisers, to help people organize how they take medication,” said senior author David Bangsberg, MD, MPH, of UCSF.

Incomplete adherence to HIV therapy is the most common cause of incomplete viral suppression, drug resistance, disease progression, and death among people living with HIV/AIDS. The subjects of this study, who were recruited from homeless shelters, free food programs, and single-room occupancy hotels, are thought to be at elevated risk for poor adherence partly because of the high rates of substance abuse, untreated mental illness, and unstable housing.

Patients in this difficult-to-treat population were given inexpensive pill box organisers to use with their antiretroviral medications. Study organisers made a total of 3,170 unannounced visits every three to six weeks to the subjects’ places of residence and compared the number of pills remaining in the patients’ possession with the number that would be expected to remain if the patients were perfectly compliant with the treatment regimen.

Pill box organisers were associated with a 4 percent improvement in adherence, 0.12 log reduction in HIV viral load, and an estimated 11 percent reduction in the risk of progression to clinical AIDS. As pill boxes are low cost, this intervention was highly cost-effective.

“While this population has often been regarded as having difficulty with adherence,” the authors write, “adherence problems are by no means limited to patients with low socioeconomic status.” Lead author Maya Petersen, PhD, from the Berkeley School of Public Health, adds, “Incomplete adherence is a major problem that prevents people from realizing the full benefits of a wide range of treatments for chronic diseases, such as hypertension and diabetes mellitus. Thus, the findings of this study have the potential to inform a wide range of diseases, not just HIV.

“It would be interesting to explore whether changes in packaging or delivery of antiretrovirals and other drugs could be used to reproduce the benefits of pill box organiser use. One model to consider is oral contraceptive therapy, which is routinely dispensed using labeled blister packs, a kind of pre-packaged version of a pill box. Antiretroviral regimens are generally more complicated, but a modification of this general model at either a pharmacy or manufacturer level might be possible, with wide-ranging patient benefits.”

Original Article adapted by ScienceDaily from materials provided by Infectious Diseases Society of America,

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