Usability of press-through packaging for bictegravir/emtricitabine/tenofovir alafenamide and its association with treatment satisfaction: a single-center preliminary evaluation combining mechanical testing and patient-reported outcomes.

Long-term care for people living with HIV (PLWH) increasingly emphasizes patient-centered outcomes, including treatment satisfaction. In Japan, bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) was introduced in a weekly press-through package (PTP) but its usability and relationship with treatment satisfaction remain unclear. This single-center study combined mechanical usability testing of PTP sheets using a benchtop device and retrospective observational analysis of PLWH. Treatment satisfaction was assessed using the HIV treatment satisfaction questionnaire (HIVTSQ). The mean push-through force for the B/F/TAF PTP was 34.6 ± 3.0N. Force-displacement curves showed a single-peak pattern, indicating immediate tablet expulsion after rupture. Five comparator PTPs showed variable forces (27.8-79.0N) and required additional pressing after rupture. In the clinical analysis, 29 B/F/TAF PTP users and 30 controls receiving other antiretroviral therapy regimens in bottle formulations were com-pared. Total HIVTSQ score did not differ significantly (60.4 ± 6.5 vs 58.2 ± 7.8, p = 0.248), whereas the score assessing the ease of the current regimen was higher in the B/F/TAF group (p < 0.05). B/F/TAF PTP demonstrated a smooth single-event push-through profile with a force in the lower-to-intermediate range among tested products. While overall treatment satisfaction was high across groups, a convenience-related item favored B/F/TAF PTP users.