Barriers to initiation of hepatitis C virus therapy in Germany: A retrospective, case-controlled study.

Despite the availability of highly effective and well-tolerated direct-acting antivirals, not all patients with chronic hepatitis C virus infection receive treatment. This retrospective, multi-centre, noninterventional, case-control study identified patients with chronic hepatitis C virus infection...

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Autores principales:	Peter Buggisch, Hans Heiken, Stefan Mauss, Bernd Weber, Maria-Christina Jung, Herbert Görne, Renate Heyne, Holger Hinrichsen, Dennis Hidde, Bettina König, Ana Gabriela Pires Dos Santos, Claus Niederau, Thomas Berg
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/bad2952be92946c19e25d0cf762e3fcb
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spelling	oai:doaj.org-article:bad2952be92946c19e25d0cf762e3fcb2021-12-02T20:11:24ZBarriers to initiation of hepatitis C virus therapy in Germany: A retrospective, case-controlled study.1932-620310.1371/journal.pone.0250833https://doaj.org/article/bad2952be92946c19e25d0cf762e3fcb2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0250833https://doaj.org/toc/1932-6203Despite the availability of highly effective and well-tolerated direct-acting antivirals, not all patients with chronic hepatitis C virus infection receive treatment. This retrospective, multi-centre, noninterventional, case-control study identified patients with chronic hepatitis C virus infection initiating (control) or not initiating (case) treatment at 43 sites in Germany from September 2017 to June 2018. It aimed to compare characteristics of the two patient populations and to identify factors involved in patient/physician decision to initiate/not initiate chronic hepatitis C virus treatment, with a particular focus on historical barriers. Overall, 793 patients were identified: 573 (72%) who received treatment and 220 (28%) who did not. In 42% of patients, the reason for not initiating treatment was patient wish, particularly due to fear of treatment (17%) or adverse events (13%). Other frequently observed reasons for not initiating treatment were in accordance with known historical barriers for physicians to initiate therapy, including perceived or expected lack of compliance (14.5%), high patient age (10.9%), comorbidities (15.0%), alcohol abuse (9.1%), hard drug use (7.7%), and opioid substitution therapy (4.5%). Patient wish against therapy was also a frequently reported reason for not initiating treatment in the postponed (35.2%) and not planned (47.0%) subgroups; of note, known historical factors were also common reasons for postponing treatment. Real-world and clinical trial evidence is accumulating, which suggests that such historical barriers do not negatively impact treatment effectiveness. Improved education is key to facilitate progress towards the World Health Organization target of eliminating viral hepatitis as a major public health threat by 2030.Peter BuggischHans HeikenStefan MaussBernd WeberMaria-Christina JungHerbert GörneRenate HeyneHolger HinrichsenDennis HiddeBettina KönigAna Gabriela Pires Dos SantosClaus NiederauThomas BergPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0250833 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Peter Buggisch Hans Heiken Stefan Mauss Bernd Weber Maria-Christina Jung Herbert Görne Renate Heyne Holger Hinrichsen Dennis Hidde Bettina König Ana Gabriela Pires Dos Santos Claus Niederau Thomas Berg Barriers to initiation of hepatitis C virus therapy in Germany: A retrospective, case-controlled study.
description	Despite the availability of highly effective and well-tolerated direct-acting antivirals, not all patients with chronic hepatitis C virus infection receive treatment. This retrospective, multi-centre, noninterventional, case-control study identified patients with chronic hepatitis C virus infection initiating (control) or not initiating (case) treatment at 43 sites in Germany from September 2017 to June 2018. It aimed to compare characteristics of the two patient populations and to identify factors involved in patient/physician decision to initiate/not initiate chronic hepatitis C virus treatment, with a particular focus on historical barriers. Overall, 793 patients were identified: 573 (72%) who received treatment and 220 (28%) who did not. In 42% of patients, the reason for not initiating treatment was patient wish, particularly due to fear of treatment (17%) or adverse events (13%). Other frequently observed reasons for not initiating treatment were in accordance with known historical barriers for physicians to initiate therapy, including perceived or expected lack of compliance (14.5%), high patient age (10.9%), comorbidities (15.0%), alcohol abuse (9.1%), hard drug use (7.7%), and opioid substitution therapy (4.5%). Patient wish against therapy was also a frequently reported reason for not initiating treatment in the postponed (35.2%) and not planned (47.0%) subgroups; of note, known historical factors were also common reasons for postponing treatment. Real-world and clinical trial evidence is accumulating, which suggests that such historical barriers do not negatively impact treatment effectiveness. Improved education is key to facilitate progress towards the World Health Organization target of eliminating viral hepatitis as a major public health threat by 2030.
format	article
author	Peter Buggisch Hans Heiken Stefan Mauss Bernd Weber Maria-Christina Jung Herbert Görne Renate Heyne Holger Hinrichsen Dennis Hidde Bettina König Ana Gabriela Pires Dos Santos Claus Niederau Thomas Berg
author_facet	Peter Buggisch Hans Heiken Stefan Mauss Bernd Weber Maria-Christina Jung Herbert Görne Renate Heyne Holger Hinrichsen Dennis Hidde Bettina König Ana Gabriela Pires Dos Santos Claus Niederau Thomas Berg
author_sort	Peter Buggisch
title	Barriers to initiation of hepatitis C virus therapy in Germany: A retrospective, case-controlled study.
title_short	Barriers to initiation of hepatitis C virus therapy in Germany: A retrospective, case-controlled study.
title_full	Barriers to initiation of hepatitis C virus therapy in Germany: A retrospective, case-controlled study.
title_fullStr	Barriers to initiation of hepatitis C virus therapy in Germany: A retrospective, case-controlled study.
title_full_unstemmed	Barriers to initiation of hepatitis C virus therapy in Germany: A retrospective, case-controlled study.
title_sort	barriers to initiation of hepatitis c virus therapy in germany: a retrospective, case-controlled study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/bad2952be92946c19e25d0cf762e3fcb
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Barriers to initiation of hepatitis C virus therapy in Germany: A retrospective, case-controlled study.

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