TY - JOUR
KW - Anti-HIV Agents/therapeutic use
KW - Electronic Prescribing
KW - Female
KW - HIV Infections/complications/drug therapy/virology
KW - Humans
KW - Longitudinal Studies
KW - Male
KW - Medication Adherence
KW - Medication Therapy Management/organization & administration
KW - Middle Aged
KW - Opioid-Related Disorders/drug therapy
KW - polypharmacy
KW - Treatment Outcome
KW - Viral Load
KW - interprofessional collaboration
KW - Medication management aid
KW - Old age
KW - substance use disorders
AU - S. S. Allemann
AU - K. M. Dursteler
AU - J. Strasser
AU - M. Vogel
AU - M. Stoeckle
AU - K. E. Hersberger
AU - I. Arnet
A1 - 
AB - BACKGROUND: 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. CASE PRESENTATION: 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. CONCLUSIONS: 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.
AD - Pharmaceutical Care Research Group, Pharmaceutical Sciences, University of Basel, Basel, Switzerland. s.allemann@unibas.ch.; Division of Addictive Disorders, University of Basel Psychiatric Hospital, Basel, Switzerland.; Division of Addictive Disorders, University of Basel Psychiatric Hospital, Basel, Switzerland.; Division of Addictive Disorders, University of Basel Psychiatric Hospital, Basel, Switzerland.; Department of Infectious Diseases, University Hospital of Basel, Basel, Switzerland.; Pharmaceutical Care Research Group, Pharmaceutical Sciences, University of Basel, Basel, Switzerland.; Pharmaceutical Care Research Group, Pharmaceutical Sciences, University of Basel, Basel, Switzerland.
BT - Harm reduction journal
C5 - HIT & Telehealth; Opioids & Substance Use
CP - 1
CY - England
DO - 10.1186/s12954-017-0182-x
IS - 1
JF - Harm reduction journal
M1 - Journal Article
N2 - BACKGROUND: 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. CASE PRESENTATION: 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. CONCLUSIONS: 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.
PP - England
PY - 2017
SN - 1477-7517; 1477-7517
SP - 017
EP - x
EP - 56+
T1 - Novel remote electronic medication supply model for opioid-dependent outpatients with polypharmacy--first long-term case study
T2 - Harm reduction journal
TI - Novel remote electronic medication supply model for opioid-dependent outpatients with polypharmacy--first long-term case study
U1 - HIT & Telehealth; Opioids & Substance Use
U2 - 28814330
U3 - 10.1186/s12954-017-0182-x
VL - 14
VO - 1477-7517; 1477-7517
Y1 - 2017
Y2 - Aug 16
ER -