Digimeds to Optimize Adherence in Patients With Hepatitis C and Increased Risk for Nonadherence (DASH)
Hepatitis C, Chronic, Nonadherence, Patient
About this trial
This is an interventional treatment trial for Hepatitis C, Chronic
Eligibility Criteria
Participants must have insurance or other method (e.g. patient assistance program) to pay for medicine.
Inclusion Criteria:
A subject must meet ALL of the following criteria to be considered for enrollment into this study:
- Adults (≥18 years old) who are diagnosed with hepatitis C deemed chronic by the investigator
- Candidate for treatment for oral direct acting agent for hepatitis C such as fixed-dose velpatasvir and sofosbuvir; fixed-dose ledipasvir and sofosbuvir; or fixed-dose glecaprevir and pibrentasvir with insurance coverage for therapy. Subjects may take other medicines that will not be co-encapsulated (e.g. ribavirin)
One of more of the following risk factors for nonadherence:
- Active alcohol or substance abuse (positive urine drug screen, illicit use in past 3 months, and/or in opioid substitution program), OR
- Patient reported history of hospitalization within past 2 years for a psychiatric comorbidity, OR
- Evidence of nonadherence to medications (e.g. self-report or refill history indicative of nonadherence), OR
- History of at least one missed clinic visit for hepatitis management, OR
- Patient-reported history of one or more transportation barriers (e.g. burden due to time and/or distance or lack of access to regular transportation) to healthcare access, which creates a risk for missed or delayed care
- Study subject has daily access to a telephone for communicating with the study personnel and study personnel contacting the study subject
- Ability to read and understand the instructions for the study.
- Willingness to adhere to all study procedures (both onsite and offsite), including troubleshooting of the product by a third-party, if needed.
- Capacity to and willing to provide informed consent. All subjects must have a signed informed consent document prior to participating in this study
- Currently owns and uses a smart phone or tablet, or has capacity to learn use of study mobile device as determined by investigator.
Adequate data connectivity at home via cellular service and/or access to a secure wireless internet (WiFi) network with the proficiency to connect a mobile device to the WiFi network.
- Note: None of the five individual sub-criteria (i.e., 3a, 3b, 3c, 3d, or 3e) alone may be used to qualify more than approximately 20% of the total study population for randomization. For example, "3d" may be used to qualify no more than 20% of the study population for randomization without an additional sub-criteria also being met (e.g., "3d" + "3a"). The data center will monitor the use of these five enrolment sub-criteria, and study sites will be notified when qualification for enrollment may no longer be based upon meeting only a specific one of the five sub-criteria alone (e.g., "3d" alone).
Exclusion Criteria:
ANY 1 of the following will exclude a subject from being enrolled into the study:
1. BMI > 40 kg/m2 2. Active skin infection or active dermatitis, OR history of chronic inflammatory skin condition including psoriasis and chronic dermatitis (except atopic dermatitis) 3. Allergy to adhesive bandages/tapes (e.g. Band-Aids®) 4. Severely decompensated cirrhosis (Child-Pugh C) or a liver transplant candidate 5. Any condition that in the investigator's opinion could preclude safe participation in the study (e.g. contraindication to hepatitis C therapy) or would preclude the subject from being able to participate in the study protocol requirements 6. Participating in a drug study or medical device clinical study (including its safety follow-up period as defined by protocol) 30 days prior to study start or completion 7. Unwilling to take a gelatin capsule because it is manufactured from animal origins (e.g. for religious reasons) 8. Allergy to food dye 10. Terminal illness (≤ 1 year of life anticipated). 10. Currently known to be pregnant or nursing an infant. 11. For women of childbearing potential, not using an acceptable form of contraception for at least 2 months prior to screening and throughout the duration of the study. Accepted means of contraception include oral contraceptive or implant, condom, diaphragm, spermicide, intrauterine device, tubal ligation, or partner with vasectomy.
12. Positive pregnancy test during screening 13. Inability to swallow the test capsule
Sites / Locations
- University of Alabama
- Zuckerberg San Francisco General Hospital
- Peak Gastroenterology Associates
- Denver Health
- Providence Health System
- Orlando Immunology Center
- Apex Clinical Research
- The Ruth M. Rothstein CORE Center
- Johns Hopkins University
- The Research Institute
- Harper University Hospital
- Henry Ford Health System
- Southwest Care Center
- Duke University Medical Center
- Harborview Medical Center
- SSM Health Dean Medical Group
Arms of the Study
Arm 1
Experimental
Digital Medicine Arm
Subjects enrolled in this single arm study will be directed to use digital medicine versions of their hepatitis C therapy for the duration of therapy.