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Patient adherence issues in the treatment of hepatitis C

Authors Larrey D, Ripault M, Pageaux G

Received 2 October 2013

Accepted for publication 4 February 2014

Published 23 May 2014 Volume 2014:8 Pages 763—773


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 5

Dominique Larrey,1,2 Marie-Pierre Ripault,1 Georges-Philippe Pageaux1

1Département d'Hépato-Gastroentérologie et Transplantation, Hôpital Saint Eloi, 2IRB-INSERM1040, Montpellier, France

Abstract: The current standard-of-care treatments for chronic hepatitis C, based on a bitherapy that combines peginterferon alpha-2a or -2b and ribavirin for all genotypes, and on a triple therapy with the addition of an antiprotease specifically for genotype 1, are associated with a limited adherence that decreases their efficacy. The main factors limiting adherence are difficulties in taking the treatment and side effects that worsen the quality of life of the patients. Programs of therapeutic education are essential to improve adherence, quality of life, likelihood of viral suppression, improvement of liver disease, and decrease of late complications. Therapeutic education should be understood as an acquisition of decisional, technical, and social competency with the purpose of making the patient able to make health choices, realize their own life plans, and use health care resources in the best manner. The patient should be placed in the center of an organization, comprising various care workers who include social service professionals and medical staff. For hepatitis C, therapeutic education may be separated into three phases: a first phase corresponding to the educative diagnosis; a second phase corresponding to support during treatment; and the third phase corresponding to support after treatment. Therapeutic education is performed using various instruments and methods specifically adapted to the needs and expectations of individual patients. Upcoming treatments for hepatitis C, with evidence for high efficacy, few side effects, and shorter duration, will certainly change the landscape of adherence and the management of therapeutic education.

Keywords: adherence to treatment, quality of life, therapeutic education, hepatitis C

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