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- Title
Novel remote electronic medication supply model for opioid-dependent outpatients with polypharmacy--first long-term case study.
- Authors
Allemann, Samuel; Dürsteler, Kenneth; Strasser, Johannes; Vogel, Marc; Stoeckle, Marcel; Hersberger, Kurt; Arnet, Isabelle
- Abstract
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.
- Subjects
SUBSTANCE-induced disorders; QUALITY of life; WELL-being; DRUG addiction complications; NEUROBEHAVIORAL disorders
- Publication
Harm Reduction Journal, 2017, Vol 14, p1
- ISSN
1477-7517
- Publication type
Article
- DOI
10.1186/s12954-017-0182-x