Real-world anti-viral treatment decisions among chronic hepatitis C patients in Taiwan: The INITIATE study

Chen Hua Liu, Ming Lung Yu, Cheng Yuan Peng, Tsai Yuan Hsieh, Yi Hsiang Huang, Wei Wen Su, Pin-Nan Cheng, Chih Lin Lin, Ching Chu Lo, Chi Yi Chen, Jyh Jou Chen, Qian Ma, Craig Brooks-Rooney, Jia Horng Kao

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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.

Original languageEnglish
Pages (from-to)1014-1023
Number of pages10
JournalJournal of the Formosan Medical Association
Volume118
Issue number6
DOIs
Publication statusPublished - 2019 Jun 1

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Chronic Hepatitis C
Taiwan
Ribavirin
Interferons
Therapeutics
Genotype
Standard of Care
Viral Load
Treatment Failure
Hepacivirus
Antiviral Agents
Hemoglobins
Fibrosis
Multivariate Analysis
Cross-Sectional Studies
Physicians

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Liu, Chen Hua ; Yu, Ming Lung ; Peng, Cheng Yuan ; Hsieh, Tsai Yuan ; Huang, Yi Hsiang ; Su, Wei Wen ; Cheng, Pin-Nan ; Lin, Chih Lin ; Lo, Ching Chu ; Chen, Chi Yi ; Chen, Jyh Jou ; Ma, Qian ; Brooks-Rooney, Craig ; Kao, Jia Horng. / Real-world anti-viral treatment decisions among chronic hepatitis C patients in Taiwan : The INITIATE study. In: Journal of the Formosan Medical Association. 2019 ; Vol. 118, No. 6. pp. 1014-1023.
@article{3d320e8557ed404a9172e981392af0ab,
title = "Real-world anti-viral treatment decisions among chronic hepatitis C patients in Taiwan: The INITIATE study",
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.",
author = "Liu, {Chen Hua} and Yu, {Ming Lung} and Peng, {Cheng Yuan} and Hsieh, {Tsai Yuan} and Huang, {Yi Hsiang} and Su, {Wei Wen} and Pin-Nan Cheng and Lin, {Chih Lin} and Lo, {Ching Chu} and Chen, {Chi Yi} and Chen, {Jyh Jou} and Qian Ma and Craig Brooks-Rooney and Kao, {Jia Horng}",
year = "2019",
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Liu, CH, Yu, ML, Peng, CY, Hsieh, TY, Huang, YH, Su, WW, Cheng, P-N, Lin, CL, Lo, CC, Chen, CY, Chen, JJ, Ma, Q, Brooks-Rooney, C & Kao, JH 2019, 'Real-world anti-viral treatment decisions among chronic hepatitis C patients in Taiwan: The INITIATE study', Journal of the Formosan Medical Association, vol. 118, no. 6, pp. 1014-1023. https://doi.org/10.1016/j.jfma.2018.10.020

Real-world anti-viral treatment decisions among chronic hepatitis C patients in Taiwan : The INITIATE study. / Liu, Chen Hua; Yu, Ming Lung; Peng, Cheng Yuan; Hsieh, Tsai Yuan; Huang, Yi Hsiang; Su, Wei Wen; Cheng, Pin-Nan; Lin, Chih Lin; Lo, Ching Chu; Chen, Chi Yi; Chen, Jyh Jou; Ma, Qian; Brooks-Rooney, Craig; Kao, Jia Horng.

In: Journal of the Formosan Medical Association, Vol. 118, No. 6, 01.06.2019, p. 1014-1023.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Real-world anti-viral treatment decisions among chronic hepatitis C patients in Taiwan

T2 - The INITIATE study

AU - Liu, Chen Hua

AU - Yu, Ming Lung

AU - Peng, Cheng Yuan

AU - Hsieh, Tsai Yuan

AU - Huang, Yi Hsiang

AU - Su, Wei Wen

AU - Cheng, Pin-Nan

AU - Lin, Chih Lin

AU - Lo, Ching Chu

AU - Chen, Chi Yi

AU - Chen, Jyh Jou

AU - Ma, Qian

AU - Brooks-Rooney, Craig

AU - Kao, Jia Horng

PY - 2019/6/1

Y1 - 2019/6/1

N2 - 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.

AB - 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.

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