Treatment of Co-occurring Psychiatric Disorders

2019 ◽  
pp. 161-174
Author(s):  
Dennis C. Daley ◽  
Antoine Douaihy
Keyword(s):  
Hepatitis C ◽  
Effective Treatment ◽  
Psychiatric Disorders ◽  
Treatment Adherence ◽  
Personal Growth ◽  
Integrated Treatment ◽  
Support Programs ◽  
Single Type ◽  
Mutual Support ◽  
Ambulatory Treatment

Effective treatment of clients with co-occurring disorders (CODs) requires the practitioner to be familiar with the continuum of care so that clients become engaged in services needed to address their disorders and related problems. Evidence suggests that clients receiving integrated treatment have higher rates of treatment adherence and improved clinical outcomes, particularly those with more persistent and chronic forms of psychiatric disorders. Therefore, it is best to provide integrated care that focuses on both types of disorders, regardless of whether the client is in an inpatient, residential, or ambulatory treatment setting. Given that clients with CODs have higher rates of problems with treatment adherence compared to those with a single type of disorder, this chapter reviews strategies to improve adherence. It also delineates recovery issues in the domains of physical/lifestyle, psychological, behavioral/cognitive, family/interpersonal/social, and personal growth/maintenance. The authors stress the potential helpfulness of mutual support programs and discuss clinical challenges such as suicide, violence, HIV/AIDS, and hepatitis C.

Reducing the Risk of Relapse

2019 ◽  
pp. 177-184
Author(s):  
Dennis C. Daley ◽  
Antoine Douaihy
Keyword(s):  
Psychiatric Illness ◽  
Warning Signs ◽  
Support Programs ◽  
Mutual Support ◽  
Early Relapse ◽  
Ambulatory Treatment ◽  
Continued Use ◽  
Initial Episode ◽  
Use Behavior ◽  
Risk Of Relapse

Any client who attempts to modify alcohol, tobacco, or drug use behavior faces the possibility of lapse or relapse. A lapse refers to the initial episode of use following a period of abstinence. A lapse may be quickly stopped by the client or it may lead to a relapse or continued use of a substance. How a client interprets and responds to a lapse plays a significant role in whether or not it leads to a relapse. The risk of lapse or relapse is highest in the first 3 months of recovery, when most relapses occur. Low motivation and poor participation in therapy or mutual support programs can raise the risk of relapse, even for clients who recently completed a residential or ambulatory treatment program. Other precipitants of relapse include psychiatric illness or an inability to cope with the challenges of recovery. Helping clients remain in therapy and identify and manage early relapse warning signs and high-risk situations are ways to lower the client’s risk of relapse.

Hepatitis C virus DAA treatment adherence patterns and SVR among people who inject drugs treated in opioid agonist therapy programs

2021 ◽  
Author(s):  
Moonseong Heo ◽  
Irene Pericot-Valverde ◽  
Lior Rennert ◽  
Matthew J Akiyama ◽  
Brianna L Norton ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Treatment Adherence ◽  
People Who Inject Drugs ◽  
Alcohol Intoxication ◽  
Sustained Viral Response ◽  
Time Frame ◽  
Agonist Therapy ◽  
Opioid Agonist ◽  
Direct Acting Antiviral

Abstract Background Adequate medication adherence is critical for achieving sustained viral response (SVR) of hepatitis C virus (HCV) among people who inject drugs (PWID). However, it is less known which patterns of direct-acting antiviral (DAA) treatment adherence are associated with SVR in this population or what factors are associated with each pattern. Methods The randomized three-arm PREVAIL study utilized electronic blister packs to obtain daily time frame adherence data in opiate agonist therapy program settings. Exact logistic regressions were applied to test the associations between SVR and six types of treatment adherence patterns. Results Of the 113 participants treated with combination DAAs, 109 (96.5%) achieved SVR. SVR was significantly associated with all pattern parameters except for number of switches between adherent and missed days: total adherent daily doses (exact AOR=1.12; 95%CI=1.04-1.22), percent total doses (1.09; 1.03-1.16), days on treatment (1.16; 1.05-1.32), maximum consecutive adherent days (1.34; 1.06-2.04), maximum consecutive non-adherent days (.85; .74-.95=.003). SVR was significantly associated with total adherent doses in the first two months of treatment, it was not in the last month. Compared to White participants (30.7±11.8(se)), Black (18.4±7.8) and Hispanic participants (19.2±6.1) had significantly shorter maximum consecutive adherent days. While alcohol intoxication was significantly associated with frequent switches, drug use was not associated with any adherence pattern. Conclusion Consistent maintenance of adequate total dose adherence over the entire course of HCV treatment is important in achieving SVR among PWID. Additional integrative addiction and medical care may be warranted for treating PWID experiencing alcohol intoxication.

scholarly journals Cognitive–behavioural therapy with older people

2007 ◽  
Vol 13 (2) ◽  
pp. 111-118 ◽  
Author(s):  
Ceri Evans
Keyword(s):  
Older People ◽  
Effective Treatment ◽  
Psychiatric Disorders ◽  
Cognitive Behavioural Therapy ◽  
Historical Context ◽  
Behavioural Therapy ◽  
Age Group ◽  
The Core ◽  
Cognitive Behavioural ◽  
The Individual

Cognitive–behavioural therapy (CBT) is an effective treatment for a number of psychiatric disorders in adults of all ages. With the proportion of the population aged 65 or over increasing steadily, it is important to be aware of how the CBT needs of this age group can be best met. This article provides an overview of CBT and the historical context of using it with older people. Although an understanding of the individual, irrespective of age, is at the core of CBT, potential modifications to the procedure and content aimed at optimising its effectiveness for older people are discussed.

Pegylated interferon-α2b plus ribavirin therapy in patients with hepatitis C and psychiatric disorders: results of a cohort study

2010 ◽  
Vol 15 (4) ◽  
pp. 599-606 ◽  
Author(s):  
Jean-Philippe Lang ◽  
◽  
Pascal Melin ◽  
Denis Ouzan ◽  
Michel Rotily ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hepatitis C ◽  
Psychiatric Disorders ◽  
Pegylated Interferon ◽  
Interferon Α2b

scholarly journals Efficacy and Safety of Ombitasvir/Paritaprevir/Ritonavir and Dasabuvir With or Without Ribavirin in Patients With Chronic Hepatitis C Virus Genotype 1 Infection Receiving Opioid Substitution Therapy: A Post Hoc Analysis of 12 Clinical Trials

2018 ◽  
Vol 5 (11) ◽  
Author(s):  
Jason Grebely ◽  
Massimo Puoti ◽  
Heiner Wedemeyer ◽  
Curtis Cooper ◽  
Mark S Sulkowski ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Hepatitis C ◽  
Treatment Adherence ◽  
Efficacy And Safety ◽  
Substitution Therapy ◽  
Hcv Treatment ◽  
Opioid Substitution Therapy ◽  
Direct Acting Antiviral ◽  
Direct Acting ◽  
Opioid Substitution

Abstract Background We evaluated the impact of opioid substitution therapy (OST) on the completion, adherence, efficacy, and safety of the 3-direct-acting antiviral regimen of ombitasvir, paritaprevir (identified by AbbVie and Enanta) co-dosed with ritonavir, and dasabuvir ± ribavirin among patients infected with hepatitis C virus (HCV) genotype (GT) 1, with or without compensated cirrhosis. Methods Data were pooled from GT1-infected patients enrolled in 12 phase II/III/IIIb clinical trials and categorized by use of OST. Patients with ongoing drug use were excluded. HCV treatment completion, treatment adherence (≥90%), sustained virologic response at post-treatment week 12 (SVR12), and adverse events were assessed. Results Of 4747 patients, 3% (n = 149) received OST. Among patients receiving OST vs those not receiving OST, 82% (n = 122) vs 52% (n = 2409) had GT1a infection; 76% (n = 113) vs 61% (n = 2792) were treatment naïve; and 17% (n = 25) vs 18% (n = 830) had cirrhosis, respectively. The proportion of patients completing HCV treatment did not differ between those receiving and not receiving OST (97% [n = 144] vs 98% [n = 4510], respectively), whereas adherence to treatment was reduced in patients receiving vs those not receiving OST (88% [n = 105] vs 97% [n = 4057], respectively). SVR12 was similar between patients receiving and not receiving OST (94% [n = 140] vs 96% [n = 4405], respectively; P = .273). Treatment was well tolerated. Conclusions Although treatment adherence was lower in patients receiving OST vs those not receiving OST, treatment completion and SVR12 were similar between groups. These data support the use of direct-acting antiviral therapies in patients receiving OST.

452 TREATMENT ADHERENCE AND ERITHROPOIETIN USE DURING ANTIVIRAL THERAPY IN RECURRENT HEPATITIS C: A “DÉJÀVUE”

2010 ◽  
Vol 52 ◽  
pp. S184
Author(s):  
V. Aguilera ◽  
M. Prieto ◽  
A. Rubín ◽  
F. Gentili ◽  
C. Ortiz Cantó ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Antiviral Therapy ◽  
Treatment Adherence ◽  
Recurrent Hepatitis ◽  
Recurrent Hepatitis C

Impact of a digital medicine programme on hepatitis C treatment adherence and efficacy in adults at high risk for non-adherence

2020 ◽  
Vol 51 (12) ◽  
pp. 1384-1396 ◽  
Author(s):  
Mark Sulkowski ◽  
Annie F. Luetkemeyer ◽  
David L. Wyles ◽  
Claudia Martorell ◽  
Andrew Muir ◽  
...  
Keyword(s):  
Hepatitis C ◽  
High Risk ◽  
Treatment Adherence ◽  
Hepatitis C Treatment ◽  
Digital Medicine
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