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BMC Health Serv Res. 2019 Feb 1;19(1):91. doi: 10.1186/s12913-019-3904-9.

Experiences with interferon-free hepatitis C therapies: addressing barriers to adherence and optimizing treatment outcomes.

Author information

1
Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers VA Medical Center, 200 Springs Road (152), Bedford, MA, 01730, USA.
2
Department of Health Law, Policy, and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA.
3
University Health Services, University of Massachusetts, 150 Infirmary Way, Amherst, MA, 01003, USA.
4
Division of Infectious Diseases, Providence VA Medical Center, 830 Chalkstone Ave, Providence, RI, 02908, USA.
5
Alpert Medical School, Brown University, 222 Richmond St, Providence, RI, 02903, USA.
6
Veterans Affairs (VA) New England Mental Illness Research, Education, and Clinical Center (MIRECC), 950 Campbell Ave, West Haven, CT, 06516, USA.
7
Department of Psychiatry, Yale University School of Medicine, 333 Cedar Street, New Haven, CT, 06511, USA.
8
Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers VA Medical Center, 200 Springs Road (152), Bedford, MA, 01730, USA. Keith.McInnes@va.gov.
9
Department of Health Law, Policy, and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA. Keith.McInnes@va.gov.

Abstract

BACKGROUND:

Millions of Americans are living with hepatitis C, the leading cause of liver disease in the United States. Medication treatment can cure hepatitis C. We sought to understand factors that contribute to hepatitis C treatment completion from the perspectives of patients and providers.

METHODS:

We conducted semi-structured interviews at three Veterans Affairs Medical Centers. Patients were asked about their experiences with hepatitis C treatments and perspectives on care. Providers were asked about observations regarding patient responses to medications and perspectives about factors resulting in treatment completion. Transcripts were analyzed using a grounded thematic approach-an inductive analysis that lets themes emerge from the data.

RESULTS:

Contributors to treatment completion included Experience with Older Treatments, Hope for Improvement, Symptom Relief, Tailored Organized Routines, and Positive Patient-Provider Relationship. Corresponding barriers also emerged, including pill burden and skepticism about treatment effectiveness and safety.

CONCLUSION:

Despite the improved side-effect profile of newer HCV medications, multiple barriers to treatment completion remain. However, providers and patients were able to identify avenues for addressing such barriers.

KEYWORDS:

Adherence; Health behaviors; Hepatitis C; Qualitative methods; Veterans

PMID:
30709352
PMCID:
PMC6359844
DOI:
10.1186/s12913-019-3904-9
[Indexed for MEDLINE]
Free PMC Article

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