Multidisciplinary approach improves outcomes in hepatitis C
Patients with hepatitis C can benefit from multidisciplinary management.
A multidisciplinary approach to the treatment of chronic hepatitis C improves patients outcomes, according to a study published in the Annals of Hepatology.
The multidisciplinary approach to hepatitis C treatment included:
- Outpatient visits to a hepatologist at various points during and after treatment
- Treatment education from a nurse who taught patients how to self-administer subcutaneous pegylated interferon; manage adverse events; treat headache, fever, and asthenia; and recognize the signs of treatment complications
- Monthly appointments with a pharmacist
- Psychiatric evaluation at various points during and after treatment
- Dermatologist appointments to treat skin problems related to antiviral treatment
The study included 514 patients who were treated with pegylated interferon plus ribavirin between August 2001 and December 2011, including patients treated before and after the implementation of a multidisciplinary approach in 2007. The researchers compared demographic, clinical, and laboratory characteristics between the pre-intervention and multidisciplinary groups.
A total of 228 patients were in the pre-intervention cohort and 286 in the multidisciplinary cohort. Age, viral genotype, previous treatment, aspartate transaminase, ferritin, and triglyceride were independent prognostic factors for sustained virologic response. After adjusting for prognostic factors, the researchers found that the rate of sustained virologic response was higher in the multidisciplinary cohort than in the pre-intervention cohort (58% versus 48%).
Adverse events that required a modification of peglyated interferon dose were observed in 7.7% of the patients in the pre-intervention group compared with 3.5% in the multidisciplinary group. Ribavirin dosage was adjusted for 9.1% of the patients in the pre-intervention group and for 12.3% of the patients in the multidisciplinary group.
Although it did not reach statistical significance, a smaller percentage of patients in the multidisciplinary group abandoned treatment compared with the pre-intervention group (2.2% versus 4.9%, respectively).
- Gallach M, Vergara M, Miquel M, et al. Effects of a multidisciplinary approach on the effectiveness of antiviral treatment for chronic hepatitis C. Ann Hepatol. 2016;15(4):524-531.