Novel remote electronic medication supply model for opioid-dependent outpatients with polypharmacy--first long-term case study

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 c...

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Main Authors: Samuel S. Allemann (Author), Kenneth M. Dürsteler (Author), Johannes Strasser (Author), Marc Vogel (Author), Marcel Stoeckle (Author), Kurt E. Hersberger (Author), Isabelle Arnet (Author)
Format: Book
Published: BMC, 2017-08-01T00:00:00Z.
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001 doaj_7d4ab6fc487748f1ad30ce43f5ebb2f3
042 |a dc 
100 1 0 |a Samuel S. Allemann  |e author 
700 1 0 |a Kenneth M. Dürsteler  |e author 
700 1 0 |a Johannes Strasser  |e author 
700 1 0 |a Marc Vogel  |e author 
700 1 0 |a Marcel Stoeckle  |e author 
700 1 0 |a Kurt E. Hersberger  |e author 
700 1 0 |a Isabelle Arnet  |e author 
245 0 0 |a Novel remote electronic medication supply model for opioid-dependent outpatients with polypharmacy--first long-term case study 
260 |b BMC,   |c 2017-08-01T00:00:00Z. 
500 |a 10.1186/s12954-017-0182-x 
500 |a 1477-7517 
520 |a 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. 
546 |a EN 
690 |a Medication adherence 
690 |a Medication management aid 
690 |a Interprofessional collaboration 
690 |a Substance use disorders 
690 |a Old age 
690 |a Public aspects of medicine 
690 |a RA1-1270 
655 7 |a article  |2 local 
786 0 |n Harm Reduction Journal, Vol 14, Iss 1, Pp 1-8 (2017) 
787 0 |n http://link.springer.com/article/10.1186/s12954-017-0182-x 
787 0 |n https://doaj.org/toc/1477-7517 
856 4 1 |u https://doaj.org/article/7d4ab6fc487748f1ad30ce43f5ebb2f3  |z Connect to this object online.