|Title:||Real-world anti-viral treatment decisions among chronic hepatitis C patients in Taiwan: The INITIATE study||Authors:||CHEN-HUA LIU
|Issue Date:||2019||Publisher:||Elsevier B.V.||Journal Volume:||118||Journal Issue:||6||Start page/Pages:||1014-1023||Source:||Journal of the Formosan Medical Association||Abstract:||
Background/Purpose: While direct-acting antiviral regimens have been approved for chronic hepatitis C (CHC) patients in Taiwan, reimbursement is limited to certain populations. Thus, pegylated interferon plus ribavirin (PEG-IFN/RBV) remains the standard of care for many patients. The aim of this study was to investigate the percentage of CHC patients who were recommended and willing to receive PEG-IFN/RBV, and to identify reasons why patients were not recommended or unwilling to receive treatment. Methods: 822 Taiwanese CHC patients were enrolled from May–August 2016 in this cross-sectional study. PEG-IFN/RBV recommendation and patient willingness to receive treatment were evaluated through surveys. Patient characteristics associated with treatment recommendation and willingness were assessed. Results: 311 (37.8%) patients were recommended PEG-IFN/RBV while 102 (12.4%) were willing to follow treatment recommendation. Rates of recommendation and willingness were lower in treatment-experienced, hepatitis C virus genotype 1 (GT1) and cirrhotic patients, and those treated in Northern Taiwan. Multivariate analyses found factors such as prior treatment experience, GT1, cirrhosis and low hemoglobin levels to be associated with lower recommendation rates while advanced age, GT1 and low baseline viral loads were associated with lower willingness rates. Physicians' top reasons for not recommending PEG-IFN/RBV included the wish to wait for better treatment options (60.3%), prior treatment failure (21.3%) and patients’ advanced age (20.9%). Patients were unwilling to receive treatment mainly due to concerns about side effects (91.4%), the wish to wait for better treatment options (71.3%) and inconvenience (25.4%). Conclusion: A minority of Taiwanese CHC patients were recommended PEG-IFN/RBV, of which few were willing to receive treatment. ? 2018 Formosan Medical Association
|ISSN:||0929-6646||DOI:||10.1016/j.jfma.2018.10.020||SDG/Keyword:||hemoglobin; peginterferon; ribavirin; virus RNA; alpha interferon; antivirus agent; adult; aged; antiviral therapy; Article; chronic hepatitis C; comorbidity; compensated liver cirrhosis; cross-sectional study; decompensated liver cirrhosis; drug cost; drug efficacy; drug safety; female; groups by age; hemoglobin blood level; Hepatitis C virus genotype 1; Hepatitis C virus genotype 2; Hepatitis C virus genotype 3; Hepatitis C virus genotype 6; Hepatitis C virus subtype 1a; Hepatitis C virus subtype 1b; human; major clinical study; male; medical decision making; middle aged; multicenter study; nonhuman; observational study; patient-reported outcome; platelet count; prospective study; sex difference; Taiwan; treatment failure; treatment response; virus load; chronic hepatitis C; combination drug therapy; drug effect; genotype; Hepacivirus; multivariate analysis; physiology; statistical model; Adult; Aged; Antiviral Agents; Cross-Sectional Studies; Drug Therapy, Combination; Female; Genotype; Hepacivirus; Hepatitis C, Chronic; Humans; Interferon-alpha; Logistic Models; Male; Middle Aged; Multivariate Analysis; Ribavirin; Taiwan; Treatment Failure; Viral Load
|Appears in Collections:||臨床醫學研究所|
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