Effect of self-efficacy among persons who inject drugs treated with direct-acting antivirals on Hepatitis C treatment initiation, duration, completion, adherence, and cure

Snehal S Lopes; Irene Pericot-Valverde; J Edward Dotherow; Paula J Lum; Lynn E Taylor; Shruti H Mehta; Judith I Tsui; Judith Feinberg; Arthur Y Kim; Brianna L Norton; Kimberly Page; Cristina Murray-Krezan; Jessica Anderson; Alison Karasz; Julia Arnsten; Phillip Moschella; Moonseong Heo; Alain H Litwin; HERO study group

doi:10.1016/j.drugalcdep.2024.111384

Effect of self-efficacy among persons who inject drugs treated with direct-acting antivirals on Hepatitis C treatment initiation, duration, completion, adherence, and cure

Drug Alcohol Depend. 2024 Sep 1:262:111384. doi: 10.1016/j.drugalcdep.2024.111384. Epub 2024 Jul 6.

Authors

Snehal S Lopes¹, Irene Pericot-Valverde², J Edward Dotherow¹, Paula J Lum³, Lynn E Taylor⁴, Shruti H Mehta⁵, Judith I Tsui⁶, Judith Feinberg⁷, Arthur Y Kim⁸, Brianna L Norton⁹, Kimberly Page¹⁰, Cristina Murray-Krezan¹¹, Jessica Anderson¹⁰, Alison Karasz¹², Julia Arnsten⁹, Phillip Moschella¹³, Moonseong Heo¹, Alain H Litwin¹⁴; HERO study group

Affiliations

¹ Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA.
² Department of Psychology, College of Behavioral, Social, and Health Sciences, Clemson University, Clemson, SC 29634, USA.
³ Department of Medicine, University of California, San Francisco, 1001 Potrero Ave, San Francisco, CA 94110, USA.
⁴ Department of Pharmacy Practice and Clinical Research, University of Rhode Island, 7 Greenhouse Road, Kingston, RI 02881, USA.
⁵ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E6546, Baltimore, MD 21205, USA.
⁶ Department of Medicine, University of Washington, 325 9th Ave, Seattle, WA 98104, USA.
⁷ Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, 930 Chestnut Ridge Road, Morgantown, WV 26505, USA; Department of Medicine, Section of Infectious Diseases, West Virginia University School of Medicine, 1 Medical Center Drive, Morgantown, WV 26506, USA.
⁸ Division of Infectious Diseases, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA; Harvard Medical School, Boston, MA 02115, USA.
⁹ Albert Einstein College of Medicine, Bronx, NY 10461, USA; Department of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA.
¹⁰ Department of Internal Medicine, University of New Mexico Health Sciences Center, University of New Mexico, MSC 10 5550, Albuquerque, NM 87131, USA.
¹¹ Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
¹² UMass Chan Medical School, University of Massachusetts Medical School, 55 Lake Ave, North Worcester, MA 01605, USA.
¹³ Department of Emergency Medicine, Prisma Health, Greenville, SC, USA; School of Health Research, Clemson University, Clemson, SC, USA; Department of Medicine, University of South Carolina School of Medicine, 876 W Faris Rd, Greenville, SC 29605, USA.
¹⁴ School of Health Research, Clemson University, Clemson, SC, USA; Department of Medicine, University of South Carolina School of Medicine, 876 W Faris Rd, Greenville, SC 29605, USA; Department of Medicine, Prisma Health, Greenville, SC, USA. Electronic address: [email protected].

PMID: 38991632
DOI: 10.1016/j.drugalcdep.2024.111384

Abstract

Background: Self-efficacy, a patient-level factor, has been shown to facilitate patient engagement in treatment and optimize treatment-related outcomes in various health contexts. Research on interventions supporting hepatitis C virus (HCV) direct-acting antiviral (DAA) treatment uptake and adherence among persons who inject drugs (PWID) is needed, but whether self-efficacy factors influence DAA treatment cascade outcomes in this population has been less studied.

Methods: Using the HERO study data, we analyzed a subset of participants with any general health self-efficacy data (n=708) measured at baseline and end-of-treatment time points using a 5-items instrument (facets: 'goal setting', 'goal attainment', 'having a positive effect', 'being in control', and 'working to improve'). The cascade outcomes included DAA treatment initiation, duration, adherence, completion, and sustained virologic response (SVR). The effect of baseline and change (Δ) scores for composite and item-level self-efficacy on the cascade outcomes was assessed using logistic regression and generalized linear models.

Results: Higher baseline composite self-efficacy [adjusted odds ratio (95 % confidence interval) =1.57 (1.07, 2.29)], 'goal attainment' [1.31 (1.03, 1.67)] and 'having a positive effect' [1.33 (1.03, 1.74)] were associated with greater likelihood of treatment initiation. 'Δ Goal attainment' was significantly associated with SVR [1.63 (1.04, 2.53)]. 'Δ Being in control' and 'Δ working to improve' were associated with treatment adherence and duration, respectively.

Conclusions: General health self-efficacy positively influences DAA treatment initiation among PWID. 'Goal attainment' facilitates the achievement of DAA treatment-related outcomes. Further studies should assess the effect of self-efficacy related to performing healthcare tasks specific to DAAs on the treatment-related outcomes.

Keywords: HCV DAA treatment adherence; Health-related self-efficacy; PWID; SVR; Treatment completion; Treatment initiation.

MeSH terms

Adult
Antiviral Agents* / therapeutic use
Female
Hepatitis C* / drug therapy
Hepatitis C* / psychology
Humans
Male
Medication Adherence* / psychology
Middle Aged
Self Efficacy*
Substance Abuse, Intravenous* / complications
Substance Abuse, Intravenous* / drug therapy
Substance Abuse, Intravenous* / psychology
Sustained Virologic Response
Treatment Outcome

Substances

Antiviral Agents