Evidence map›Paper›PMID 31345218›Full record

Observational studyBMC health services research2019

Adoption of direct-acting antiviral medications for hepatitis C: a retrospective observational study.

Leah L Zullig, Haresh L Bhatia, Ziad F Gellad, Mark Eatherly, Rochelle Henderson, Hayden B Bosworth

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Leah L ZulligCenter of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care Center, 411 West Chapel Hill Street, Suite 600, Durham, NC, 27701, USA.
Haresh L BhatiaExpress Scripts Holding Company, St. Louis, MO, USA.
Ziad F GelladCenter of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care Center, 411 West Chapel Hill Street, Suite 600, Durham, NC, 27701, USA.
Mark EatherlyExpress Scripts Holding Company, St. Louis, MO, USA.
Rochelle HendersonExpress Scripts Holding Company, St. Louis, MO, USA.
Hayden B BosworthCenter of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care Center, 411 West Chapel Hill Street, Suite 600, Durham, NC, 27701, USA. hayden.bosworth@duke.edu.ORCID http://orcid.org/0000-0001-6188-9825
Express Scripts Holding Company (United States) · USDuke University · USDurham VA Health Care System · US

Funding

HSRD VA IK2 HX001555
6 · The paper itself

Abstract

backgroundApproximately 3.5 million Americans are infected with the hepatitis C virus (HCV). Although many patients with HCV are asymptomatic, HCV is the leading cause of infection-related death in the U.S. With advances in curative medication therapy for HCV, many of these deaths are preventable. Access to innovative therapies may be unevenly distributed. Our objective was to describe medication prescribers' adoption of innovative HCV pharmacotherapy across prescriber, geographical location, and time.

methodsThis is a retrospective, secondary data analysis among a national cohort of patients prescribed direct-acting antiviral HCV medications with curative intent. We assessed prescriptions by time, geographic location, and provider type.

resultsThe peak of the adoption rate occurred within 45 days; nearly one-sixth of all prescribers had already prescribed one of the new drugs. Geographical regions (Midwest, South, and West all p ≥ 0.05) nor gender (p = 0.455) of a prescriber impacted adoption. Similarly, patient income did not influence the likelihood of a prescriber to adopt the new drugs earlier (p = 0.175). Gastroenterologists or hepatologists were more likely earlier adopters compared to primary care physicians (p = 0.01).

conclusionsBecause of the relative advantage of newer therapies, we anticipated that there would be an initial surge as early adopters prescribed the new medications and use would dwindle over time as the initial HCV cohort was cured. The data demonstrate that our hypothesis is essentially supported. There is a reduction in prescriptions at approximately 5 months post-approval and treatment is typically required for 3 months. There has been a surge in clinicians' adoption of innovative HCV treatments. As patients are cured of their infection, we anticipate a decreased need for chronic management of HCV.

trial registrationNot applicable.

Indexed as

Healthcare DisparitiesTherapies, InvestigationalAdultAntiviral AgentsDrug PrescriptionsFemaleGeographyHepatitis CHumansMalePhysiciansPractice Patterns, Physicians'Retrospective StudiesTime FactorsUnited StatesAntiviral AgentsDissemination researchHealth services researchInfectious diseaseHepatitis C.

Identifiers

PMID31345218
PMCPMC6657375
OpenAlexW2963564864

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.