Novel remote electronic medication supply model for opioid-dependent outpatients with polypharmacy––first long-term case study
Identifieur interne : 000335 ( Main/Exploration ); précédent : 000334; suivant : 000336Novel remote electronic medication supply model for opioid-dependent outpatients with polypharmacy––first long-term case study
Auteurs : Samuel S. Allemann [Suisse] ; Kenneth M. Dürsteler [Suisse] ; Johannes Strasser [Suisse] ; Marc Vogel [Suisse] ; Marcel Stoeckle [Suisse] ; Kurt E. Hersberger [Suisse] ; Isabelle Arnet [Suisse]Source :
- Harm Reduction Journal [ 1477-7517 ] ; 2017.
Abstract
Patients with substance use disorders grow older thanks to effective treatments. Together with a high prevalence of comorbidities, psychological problems, and low social support, these patients are at high risk for medication non-adherence. Established treatment facilities face challenges to accommodate these complex patients within their setting. Electronic medication management aids (e-MMAs) might be appropriate to simultaneously monitor and improve adherence for these patients.
We report the first long-term experiences with a novel remote electronic medication supply model for two opioid-dependent patients with HIV. John (beginning dementia, 52 years, 6 tablets daily at 12 am) and Mary (frequent drug holidays, 48 years, 5–6 tablets daily at 8 pm) suffered from disease progression due to non-adherence. We electronically monitored adherence and clinical outcomes during 659 (John) and 953 (Mary) days between July 2013 and April 2016. Both patients retrieved over 90% of the pouches within 75 min of the scheduled time. Technical problems occurred in 4% (John) and 7.2% (Mary) of retrievals, but on-site support was seldom required. Viral loads fell below detection limits during the entire observation period.
Continuous medication supply and persistence with treatment of over 1.7 years, timing adherence of more than 90%, and suppressed HIV viral load are first results supporting the feasibility of the novel supply model for patients on opioid-assisted treatment and polypharmacy.
Url:
DOI: 10.1186/s12954-017-0182-x
PubMed: 28814330
PubMed Central: 5559800
Affiliations:
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Hersberger</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1937 0642</institution-id><institution-id institution-id-type="GRID">grid.6612.3</institution-id><institution>Pharmaceutical Care Research Group, Pharmaceutical Sciences,</institution><institution>University of Basel,</institution></institution-wrap>Basel, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Basel</wicri:regionArea></affiliation></author><author><name sortKey="Arnet, Isabelle" sort="Arnet, Isabelle" uniqKey="Arnet I" first="Isabelle" last="Arnet">Isabelle Arnet</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1937 0642</institution-id><institution-id institution-id-type="GRID">grid.6612.3</institution-id><institution>Pharmaceutical Care Research Group, Pharmaceutical Sciences,</institution><institution>University of Basel,</institution></institution-wrap>Basel, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Basel</wicri:regionArea></affiliation></author></analytic><series><title level="j">Harm Reduction Journal</title><idno type="eISSN">1477-7517</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p id="Par1">Patients with substance use disorders grow older thanks to effective treatments. Together with a high prevalence of comorbidities, psychological problems, and low social support, these patients are at high risk for medication non-adherence. Established treatment facilities face challenges to accommodate these complex patients within their setting. Electronic medication management aids (e-MMAs) might be appropriate to simultaneously monitor and improve adherence for these patients.</p></sec><sec><title>Case presentation</title><p id="Par2">We report the first long-term experiences with a novel remote electronic medication supply model for two opioid-dependent patients with HIV. John (beginning dementia, 52 years, 6 tablets daily at 12 am) and Mary (frequent drug holidays, 48 years, 5–6 tablets daily at 8 pm) suffered from disease progression due to non-adherence. We electronically monitored adherence and clinical outcomes during 659 (John) and 953 (Mary) days between July 2013 and April 2016. Both patients retrieved over 90% of the pouches within 75 min of the scheduled time. Technical problems occurred in 4% (John) and 7.2% (Mary) of retrievals, but on-site support was seldom required. Viral loads fell below detection limits during the entire observation period.</p></sec><sec><title>Conclusions</title><p id="Par3">Continuous medication supply and persistence with treatment of over 1.7 years, timing adherence of more than 90%, and suppressed HIV viral load are first results supporting the feasibility of the novel supply model for patients on opioid-assisted treatment and polypharmacy.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Dursteler Macfarland, Km" uniqKey="Dursteler Macfarland K">KM Dursteler-MacFarland</name></author><author><name sortKey="Vogel, M" uniqKey="Vogel M">M Vogel</name></author><author><name sortKey="Wiesbeck, Ga" uniqKey="Wiesbeck G">GA Wiesbeck</name></author><author><name sortKey="Petitjean, Sa" uniqKey="Petitjean S">SA Petitjean</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lima, Vd" uniqKey="Lima V">VD 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Dieckhaus</name></author><author><name sortKey="Watrous, E" uniqKey="Watrous E">E Watrous</name></author><author><name sortKey="Williams, Ab" uniqKey="Williams A">AB Williams</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Sokol, Mc" uniqKey="Sokol M">MC Sokol</name></author><author><name sortKey="Mcguigan, Ka" uniqKey="Mcguigan K">KA McGuigan</name></author><author><name sortKey="Verbrugge, Rr" uniqKey="Verbrugge R">RR Verbrugge</name></author><author><name sortKey="Epstein, Rs" uniqKey="Epstein R">RS Epstein</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Roebuck, Mc" uniqKey="Roebuck M">MC Roebuck</name></author><author><name sortKey="Liberman, Jn" uniqKey="Liberman J">JN Liberman</name></author><author><name sortKey="Gemmill Toyama, M" uniqKey="Gemmill Toyama M">M Gemmill-Toyama</name></author><author><name sortKey="Brennan, Ta" uniqKey="Brennan T">TA Brennan</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Suisse</li></country></list><tree><country name="Suisse"><noRegion><name sortKey="Allemann, Samuel S" sort="Allemann, Samuel S" uniqKey="Allemann S" first="Samuel S." last="Allemann">Samuel S. Allemann</name></noRegion><name sortKey="Arnet, Isabelle" sort="Arnet, Isabelle" uniqKey="Arnet I" first="Isabelle" last="Arnet">Isabelle Arnet</name><name sortKey="Dursteler, Kenneth M" sort="Dursteler, Kenneth M" uniqKey="Dursteler K" first="Kenneth M." last="Dürsteler">Kenneth M. Dürsteler</name><name sortKey="Hersberger, Kurt E" sort="Hersberger, Kurt E" uniqKey="Hersberger K" first="Kurt E." last="Hersberger">Kurt E. Hersberger</name><name sortKey="Stoeckle, Marcel" sort="Stoeckle, Marcel" uniqKey="Stoeckle M" first="Marcel" last="Stoeckle">Marcel Stoeckle</name><name sortKey="Strasser, Johannes" sort="Strasser, Johannes" uniqKey="Strasser J" first="Johannes" last="Strasser">Johannes Strasser</name><name sortKey="Vogel, Marc" sort="Vogel, Marc" uniqKey="Vogel M" first="Marc" last="Vogel">Marc Vogel</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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