BMC Infect Dis. 2013 May 23;13:234. doi: 10.1186/1471-2334-13-234.
Infection with hepatitis C virus (HCV) is associated with high morbidity and increased mortality but many patients avoid initiation of treatment or report challenges with treatment completion. The study objective was to identify motivators and barriers for treatment initiation and completion in a community sample of HCV-infected patients in the United States.
Survey methods were employed to identify factors reported by patients as important in their decision to start or complete HCV treatment. Study participants included 120 HCV-infected individuals: 30 had previously completed treatment with pegylated interferon/ribavirin (PR), 30 had discontinued PR, 30 were treated with PR at the time of the survey, and 30 were treatment‒naïve. Telephone interviews occurred between May and August of 2011 and employed a standardized guide. Participants assigned factors a rating from 1 (not at all important) to 5 (extremely important). Trained researchers coded and analyzed interview transcripts.
Of 33 factors, expected health problems from not treating HCV infection was reported as most encouraging for treatment initiation and completion, while treatment side effects was most discouraging. Sixty-nine percent of participants reported that the ability to obtain information during treatment on the likelihood of treatment success (i.e., results of viral load testing) would motivate them to initiate therapy. Median preferred timing for learning about test results was 5 weeks (range: 1-23 weeks).
Understanding challenges and expectations from patients is important in identifying opportunities for education to optimize patient adherence to their HCV treatment regimen.
丙型肝炎病毒 (HCV) 感染与高发病率和死亡率增加有关,但许多患者避免开始治疗或报告完成治疗存在困难。本研究的目的是确定美国社区 HCV 感染患者群体中开始和完成治疗的动机和障碍。
采用调查方法确定患者报告的对其开始或完成 HCV 治疗决策有重要影响的因素。研究参与者包括 120 名 HCV 感染个体:30 名曾完成聚乙二醇干扰素/利巴韦林 (PR) 治疗,30 名停止 PR 治疗,30 名在调查时接受 PR 治疗,30 名未接受治疗。电话访谈于 2011 年 5 月至 8 月进行,并采用标准化指南。参与者将因素评分从 1(一点也不重要)到 5(极其重要)。经过培训的研究人员对访谈记录进行编码和分析。
在 33 个因素中,不治疗 HCV 感染预期出现的健康问题被报告为最能鼓励开始和完成治疗的因素,而治疗副作用则是最令人沮丧的因素。69%的参与者表示,在治疗期间能够获得有关治疗成功率(即病毒载量检测结果)的信息,这将激励他们开始治疗。参与者中位数首选获知检测结果的时间为 5 周(范围:1-23 周)。
了解患者的挑战和期望对于确定教育机会以优化患者对 HCV 治疗方案的依从性非常重要。