{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:48:28Z","timestamp":1787237308498,"version":"build-2736575974"},"reference-count":37,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The COVID-19 pandemic is currently delaying the process of chronic hepatitis C (HCV) eradication, since most of the chronic diseases are neglected. Thus, there is a need for alternative programs for HCV therapy implementation and disease monitoring. Our aim was to provide a multidisciplinary approach, so that HCV-infected patients from distant locations may benefit from HCV antivirals during the COVID-19 outbreak and within the lockdown period in Romania. Previously diagnosed HCV patients willing to participate in this telemedicine pilot study were included. Patient characteristics and medical adherence were assessed and compared to the year preceding the pandemic. We proposed a multidisciplinary approach by using a telemedicine program for HCV therapy monitoring. Patients also received a satisfaction questionnaire after delivering the sustained virologic response (SVR) result. A total of 41 patients agreed to participate in this study. The medication adherence was 100% for patients included in the telemedicine group, with a statistically significant difference from the medication adherence of the patients treated in 2019. The satisfaction item score was 4.92 out of 5 and our results (r = \u22120.94, p &lt; 0.0001) suggested that older patients embraced the telemedicine program less, but with the same success in terms of SVR (100%) and medication adherence (100%). Our pilot study offers the first example of a telemedicine program in Romania for HCV therapeutic management. During the lockdown period, telemedicine has served as a reliable tool and novel alternative for conventional monitoring of patients treated with direct antiviral agents and should be further considered even following the pandemic.<\/jats:p>","DOI":"10.3390\/ijerph18073694","type":"journal-article","created":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T10:44:01Z","timestamp":1617273841000},"page":"3694","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Telemedicine Chronic Viral Hepatitis C Treatment during the Lockdown Period in Romania: A Pilot Study"],"prefix":"10.3390","volume":"18","author":[{"given":"Irina Paula","family":"Doica","sequence":"first","affiliation":[{"name":"Gastroenterology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan Nicolae","family":"Florescu","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Nicoleta","family":"Oancea","sequence":"additional","affiliation":[{"name":"Pharmacy I Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1374-276X","authenticated-orcid":false,"given":"Adina","family":"Turcu-Stiolica","sequence":"additional","affiliation":[{"name":"Pharmacoeconomics Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela-Simona","family":"Subtirelu","sequence":"additional","affiliation":[{"name":"Pharmacoeconomics Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8982-9645","authenticated-orcid":false,"given":"Gindrovel","family":"Dumitra","sequence":"additional","affiliation":[{"name":"Family Medicine Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ion","family":"Rogoveanu","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan Ionut","family":"Gheonea","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan Silviu","family":"Ungureanu","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2808","DOI":"10.1007\/s42399-020-00588-3","article-title":"Update on Hepatitis C Epidemiology: Unaware and Untreated Infected Population Could Be the Key to Elimination","volume":"2","author":"Stasi","year":"2020","journal-title":"SN Compr. Clin. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.1016\/j.jhep.2020.08.006","article-title":"Hepatic benefits of HCV cure","volume":"73","author":"Calvaruso","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_3","unstructured":"Polaris Observatory (2020, December 30). The authoritative Resource for Epidemiological Data, Modeling Tools, Training, and Decision Analytics to Support Global Elimination of Hepatitis B and C by 2030. Available online: http:\/\/www.hepbunited.org\/assets\/Webinar-Slides\/8b54a78215\/POLARIS-Brief-181217.pdf."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1159\/000510765","article-title":"Impacts of COVID-19 on Liver Cancers: During and after the Pandemic","volume":"9","author":"Chan","year":"2020","journal-title":"Liver Cancer"},{"key":"ref_5","unstructured":"(2020, December 30). Decree Signed by the PRESIDENT of Romania, Mr. Klaus Iohannis, Regarding the Establishment of the Lockdown on the Romanian Territory. Available online: https:\/\/www.presidency.ro\/ro\/media\/decret-semnat-de-presedintele-romaniei-domnul-klaus-iohannis-privind-instituirea-starii-de-urgenta-pe-teritoriul-romaniei."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1016\/j.jaip.2020.03.008","article-title":"Telemedicine in the Era of COVID-19","volume":"8","author":"Portnoy","year":"2020","journal-title":"J. Allergy Clin. Immunol. Pr."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Jim\u00e9nez-Rodr\u00edguez, D., Garc\u00eda, A.S., Robles, J.M., Salvador, M.D.M.R., Ronda, F.J.M., and Arrogante, O. (2020). Increase in Video Consultations During the COVID-19 Pandemic: Healthcare Professionals\u2019 Perceptions about Their Implementation and Adequate Management. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17145112"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/s11908-019-0697-2","article-title":"The Current and Future Use of Telemedicine in Infectious Diseases Practice","volume":"21","author":"Coombes","year":"2019","journal-title":"Curr. Infect. Dis. Rep."},{"key":"ref_9","unstructured":"(2020, December 30). Romanian Health Insurance House. Available online: http:\/\/www.cnas.ro\/category\/lista-medicamentelor.html."},{"key":"ref_10","unstructured":"American Telemedicine Association (2020, December 30). About Telemedicine. Available online: https:\/\/www.americantelemed.org."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3849","DOI":"10.3748\/wjg.v25.i29.3849","article-title":"Improving cirrhosis care: The potential for telemedicine and mobile health technologies","volume":"25","author":"Stotts","year":"2019","journal-title":"World J. Gastroenterol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1080\/17474124.2020.1822734","article-title":"Feasibility of telehealth in the management of autoimmune hepatitis before and during the COVID-19 pandemic","volume":"14","author":"Efe","year":"2020","journal-title":"Expert Rev. Gastroenterol. Hepatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1111\/jvh.13017","article-title":"Increased diagnosis and treatment of hepatitis C in prison by universal offer of testing and use of telemedicine","volume":"26","author":"Morey","year":"2019","journal-title":"J. Viral Hepat."},{"key":"ref_14","first-page":"550","article-title":"The contribution of telemedicine to hepatitis C elimination in a correctional facility","volume":"111","author":"Alia","year":"2019","journal-title":"Rev. Espa\u00f1ola Enferm. Dig."},{"key":"ref_15","first-page":"103","article-title":"Development of a Software for Treat-To-Target Strategy Implemen-tation and Increasing Quality of Life in Patients with Inflammatory Bowel Disease","volume":"46","author":"Popa","year":"2020","journal-title":"Curr. Health Sci. J."},{"key":"ref_16","unstructured":"(2021, January 14). Emergency Ordinance Regarding Telemedicine to Amend and Complete the Romanian Law no. 95\/2006 on Health Care Reform. Available online: http:\/\/legislatie.just.ro\/Public\/DetaliiDocument\/233458."},{"key":"ref_17","unstructured":"(2021, January 14). Decision, no. 252\/2020 on the Establishment of Measures in the Field of Health during the Establishment of the State of Emergency on Romania\u2019s Territory. Available online: http:\/\/www.cnas.ro\/cjastm\/post\/type\/local\/hg-252-2020-privind-stabilirea-unor-masuri-in-domeniul-sanatatii-pe-perioada-instituirii-starii-de-u.html."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1177\/0025817220926926","article-title":"Telemedicine during COVID-19 pandemic: Advantage or critical issue?","volume":"88","author":"Perrone","year":"2020","journal-title":"Medico-Legal J."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Turcu-Stiolica, A., Gheonea, D.I., Ungureanu, B.S., Doica, I.P., Subtirelu, M.S., and Rogoveanu, I. (2021). Translation and Cultural Adaptation of the Telemedicine Satisfaction Questionnaire for Use in Romania. Value Health, in press.","DOI":"10.1016\/j.jval.2021.04.965"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1258\/135763303321159693","article-title":"Development of the Telemedicine Satisfaction Questionnaire to evaluate patient satisfaction with telemedicine: A preliminary study","volume":"9","author":"Yip","year":"2003","journal-title":"J. Telemed. Telecare"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.jval.2018.08.006","article-title":"Methods for Measuring Multiple Medication Adherence: A Systematic Review\u2013Report of the ISPOR Medication Adherence and Persistence Special Interest Group","volume":"22","author":"Pednekar","year":"2019","journal-title":"Value Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/19312458.2020.1718629","article-title":"Use Omega Rather than Cronbach\u2019s Alpha for Estimating Reliability. But\u2026","volume":"14","author":"Hayes","year":"2020","journal-title":"Commun. Methods Meas."},{"key":"ref_23","unstructured":"McDonald, R.P. (1999). Test Theory: A Unified Treatment, Lawrence Erlbaum."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"979","DOI":"10.3758\/BF03192993","article-title":"Methods for the Behavioral, Educational, and Social Sciences: An R package","volume":"39","author":"Kelley","year":"2007","journal-title":"Behav. Res. Methods"},{"key":"ref_25","unstructured":"(2021, January 14). Implementing Telemedicine Services during COVID-19: Guiding Principles and Considerations for a Stepwise Approach. Available online: https:\/\/iris.wpro.who.int\/bitstream\/handle\/10665.1\/14651\/WPR-DSE-2020-032-eng.pdf."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"579177","DOI":"10.3389\/fpsyg.2020.579177","article-title":"Impact of the COVID-19 Pandemic on Health-Related Quality of Life, Anxiety, and Training Among Young Gastroenterologists in Romania","volume":"11","author":"Ungureanu","year":"2020","journal-title":"Front. Psychol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"100169","DOI":"10.1016\/j.jhepr.2020.100169","article-title":"Impact of COVID-19 on the care of patients with liver disease: EASL-ESCMID position paper after 6 months of the pandemic","volume":"2","author":"Boettler","year":"2020","journal-title":"JHEP Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/j.jhep.2020.05.013","article-title":"High mortality rates for SARS-CoV-2 infection in patients with pre-existing chronic liver disease and cirrhosis: Preliminary results from an international registry","volume":"73","author":"Moon","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Case, L., Wright, J., and Ryan, Y. (2019). Comparison of hepatitis C treatment outcomes between telehepatology and specialty care clinics in the era of direct-acting antivirals. J. Telemed. Telecare, 1357633X19885750.","DOI":"10.1177\/1357633X19885750"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Aydemir, S., Ocak, S., Sayg\u0131l\u0131, S., Hopurcuo\u011flu, D., Ha\u015flak, F., K\u0131yk\u0131m, E., Zeybek, \u00c7.A., Celkan, T., Demirgan, E.B., and Kasap\u00e7opur, \u00d6. (2020). Telemedicine Applications in a Tertiary Pediatric Hospital in Turkey During COVID-19 Pandemic. Telemed. e-Health.","DOI":"10.1089\/tmj.2020.0381"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Santonicola, A., Zingone, F., Camera, S., Siniscalchi, M., and Ciacci, C. (2020). Telemedicine in the COVID-19 era for Liver Trans-plant Recipients: An Italian lockdown area experience. Clin. Res. Hepatol. Gastroenterol.","DOI":"10.1016\/j.clinre.2020.07.013"},{"key":"ref_32","first-page":"217","article-title":"Preliminary Results of the Micro-Elimination Project of Hepatitis C in a Disadvantaged Town in South-West of Romania-Or\u015fova","volume":"46","author":"Butaru","year":"2020","journal-title":"Curr. Health Sci. J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e159","DOI":"10.1016\/j.japh.2020.11.008","article-title":"Developing a multidisciplinary HCV direct-acting antivirals utilization management and assessment program","volume":"61","author":"Ajlan","year":"2021","journal-title":"J. Am. Pharm. Assoc."},{"key":"ref_34","first-page":"74","article-title":"Feasibility and outcomes of a hepatitis C screening programme in community pharmacies","volume":"133","author":"Gauld","year":"2020","journal-title":"N. Z. Med. J."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Jim\u00e9nez-Rodr\u00edguez, D., Ruiz-Salvador, D., Salvador, M.D.M.R., P\u00e9rez-Heredia, M., Ronda, F.J.M., and Arrogante, O. (2020). Consensus on Criteria for Good Practices in Video Consultation: A Delphi Study. Int. J. Environ. Res. Public Heal., 17.","DOI":"10.3390\/ijerph17155396"},{"key":"ref_36","unstructured":"Greenhalgh, T., and IRIHS Research Group (2021, January 14). Video Consultations: A Guide to Practice. Available online: https:\/\/bjgplife.com\/wp-content\/uploads\/2020\/03\/Video-consultations-a-guide-for-practice.pdf."},{"key":"ref_37","unstructured":"Hernandez, J.L.P., Mendoza, R.L., Martinez, J.L., Roldan, J.F.T., Rosales, P.A.C., Arredondo, H.A.M., Gonzalez, V.R., Silva, L.D.L.C., Santana-Vargas, D., and Tijera, M.D.F.H.D.L. (2020). Chronic viral hepatitis c micro-elimination program using telemedicine. The mexican experience. Rev. Espa\u00f1ola Enferm. Dig."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/7\/3694\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:26:01Z","timestamp":1760361961000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/7\/3694"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,1]]},"references-count":37,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,4]]}},"alternative-id":["ijerph18073694"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18073694","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,1]]}}}