Improving Outcome in Hepatitis C Management: A Need for Dedicated Multi-disciplinary Service to Improve Compliance with Treatment

Abstract

AIM: Hepatitis C infection has affected more than 170 millions people worldwide. In recent years, the combination of Pegaylated Interferon and Ribavirin has improved treatment outcomes and more than 50% of patients can achieve sustained virological response after 24-48 weeks of therapy. Poor compliance with medication and follow up are two main reasons leading to treatment failure. Dedicated and organized health care services have demonstrated to significantly improve compliance with medication across a broad range of conditions and disease severities. METHODS: To assess the improvement in treatment compliance, we retrospectively studied 82 patients referred to our hepatology clinic at local district general hospital UK. Twenty-six of these patients received dedicated multidisciplinary care (MDC) from a team comprised of a hepatologist, a specialist nurse, community support team and psychological support worker throughout the duration of their treatment, while the rest of 56 patients received routine care without any community or psychological support. RESULTS: Treatment compliance was 95% in the intervention group as compared to 46% in those treated with the ‘traditional’ care (p=0.009). Overall sustained virological response (SVR) was found to be 69% in MDC group compared to 20% in those received ‘traditional’ care (p=0.001). CONCLUSION: In conclusion, our study demonstrated that appropriate service reconfiguration for HCV infected individuals results in improved patient compliance with medications as well as with follow–up appointments, leading to successful treatment outcome.