Education by a nurse increases response of patients with chronic hepatitis C to therapy with peginterferon-α2a and ribavirin
| Autor: | Dominique Larrey, Annie Salse, Georges Philippe Pageaux, Guy Boulay, Natalia Karlova, Emmanuel Vaucher, Jean Pierre Arpurt, Valérie Hyrailles–Blanc, Jean Pierre Daures, Birame Niang, Olivier Boutet, D. Ribard |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Nurses Group A Antiviral Agents Group B Medication Adherence Polyethylene Glycols Liver disease chemistry.chemical_compound Nursing Ribavirin medicine Humans Prospective Studies Prospective cohort study Hepatology Education Medical business.industry Gastroenterology Interferon-alpha Hepatitis C Odds ratio Hepatitis C Chronic Middle Aged medicine.disease Recombinant Proteins Clinical trial Treatment Outcome chemistry Female business |
| Zdroj: | Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 9(9) |
| ISSN: | 1542-7714 |
| Popis: | Education of patients with chronic hepatitis C has been proposed to increase response to therapy with peginterferon and ribavirin. We performed a prospective study to determine the effects of systematic consultation by a nurse on patient adherence and the efficacy of therapy.We analyzed data from 244 patients who received either systematic consultation after each medical visit from a nurse who used a standard evaluation grid and provided information about the disease and treatment (group A [GrA], n = 123) or the conventional clinical follow-up procedure (group B [GrB], n = 121). Treatment lasted 24 to 48 weeks.Characteristics of each group were similar at baseline, including prior treatment (42.6% in GrA and 36.0% in GrB). Overall, GrA had significantly better adherence to treatment than GrB (74.0% vs 62.8%), especially among patients who received 48 weeks of treatment (69.7% vs 53.2%; P.03). Significantly more patients in GrA had a sustained virologic response, compared with GrB overall (38.2% vs 24.8%; P.02), as well as treatment-naive patients (47.1% vs 30.3%; P.05), and those with genotypes 1, 4, or 5 infections (31.6% vs 13.3%; P.007). There were no differences between GrA and GrB in response of patients with genotypes 2 or 3 infections or advanced fibrosis. Prognostic factors for a sustained virologic response (based on bivariate and multivariate analyses) were virologic response at week 12 (odds ratio [OR], 1.9; P.0001), genotypes 2 or 3 (OR, 2.9; P.0001), therapeutic education (OR, 2.5; P.02), and lack of previous treatment (OR, 2.3; P.005).Therapeutic education by a specialized nurse increases the response of patients with hepatitis C to therapy, particularly in difficult-to-treat patients. |
| Databáze: | OpenAIRE |
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