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

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Title:	Adherence to ribavirin in chronic hepatitis C patients on antiviral treatment: Results from a randomized controlled trial using real-time medication monitoring
Author(s):	Vlerken, L.G. Van; Lieveld, F.I.; Meer, S. van; Koek, G.H.; Nieuwkerk, K.M. van; Friederich, P.; Arends, J.E.; Siersema, P.D.; Burger, D.M. ; Erpecum, K.J. van
Publication year:	2016
Source:	Clinics and Research in Hepatology and Gastroenterology, vol. 40, iss. 5, (2016), pp. 622-630
ISSN:	2210-7401
DOI:	https://doi.org/10.1016/j.clinre.2015.12.014
Publication type:	Article / Letter to editor
Please use this identifier to cite or link to this item : https://hdl.handle.net/2066/170861
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Subject:	Radboudumc 14: Tumours of the digestive tract RIHS: Radboud Institute for Health Sciences Radboudumc 4: lnfectious Diseases and Global Health RIHS: Radboud Institute for Health Sciences
Organization:	Gastroenterology Clinical Pharmacy
Journal title:	Clinics and Research in Hepatology and Gastroenterology
Volume:	vol. 40
Issue:	iss. 5
Page start:	p. 622
Page end:	p. 630
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.