April 28, 2014 – Curant Health Director of Clinical Service, Vickie Andros, in MedCity News – These are exciting times regarding hepatitis c treatments. The outlook for patients with hepatitis C has greatly improved with available treatment options offering a cure for many. Until 2011, the standard of care for patients with hepatitis C was combination treatment of pegylated interferon and ribavirin. Treatment with peginterferon and ribavirin has been associated with significant side effects, worsening fatigue and decline in health-related quality of life.(1) Nonadherence to peginterferon and ribavirin treatment for hepatitis C has been a major barrier to treatment success. (2)
The landscape of treatment for hepatitis C is rapidly changing with approval of oral agents that produce better cure rates, are better tolerated and provide shorter duration of treatment. Numerous new agents are also expected to become available in 2014 and 2015 that will offer more effective, simpler all oral, interferon-free treatment regimens. For these reasons, many patients will demand these newer treatments.
Studies examining adherence to hepatitis c treatments and combinations with peginterferon and ribavirin have shown an increased risk of virologic failure in poorly adherent patients. (3)
Due to the high cost of these new treatments, the possibility that the virus could become resistant if adherence is not optimal, and that good outcomes are dependent upon adherence (4), it is important to provide patient support to ensure adherence to treatment is maintained throughout the course of therapy.
Physicians may not be able to meet the current and future demands of increased access to care and there exists the lack of capacity of our system to provide comprehensive care to patients. Other health care providers are needed to support the physician and the patient.
Clinicians need to educate patients regarding disease progression, potential of long-term clinical consequences if treatment is postponed, and challenges of treatment-related side effects. Understanding factors associated with patient non-adherence is also important in identifying opportunities for education. Side effects, including fatigue, headache and depression, are the most common reason for discontinuing treatment.
To read Vickie’s full article, visit MedCity News.
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