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Formal HCV education improved time to therapy initiation, response

Patients with hepatitis C who participated in a formal class on the illness initiated therapy more quickly and experienced sustained virologic response more frequently than those who did not attend in a recent study.

Researchers conducted a cross-sectional survey of 94 primary care providers in San Francisco and performed a retrospective records review of 118 patients with HCV before and after development of a formal HCV education class. The 2-hour class was presented by a liver clinic nurse practitioner and included topics on the symptoms, diagnosis and transmission of HCV, along with candidacy for, response to and side effects of therapy.

Class participants (n=60) had a significantly shorter time to HCV treatment initiation than those who did not participate (n=58) (median 136 days vs. 284 days; P<.0001). More participants experienced sustained virologic response (SVR) to treatment (68% vs. 50%), had lower discontinuation rates due to side effects (3% vs. 12% of cases) and had fewer relapses (16% vs. 28%) than those who did not attend class. None of these differences was statistically significant.

Multivariate analysis indicated that participation (OR=3.0; 95% CI, 1.1-7.9) and having an HCV genotype other than 1 (OR=6.17; 95% CI, 2.3-12.7) were significantly associated with SVR. Investigators noted a significant negative association between HCV education and the time to therapy initiation (P=.028) after adjusting for age, sex, race, HCV genotype and severity of liver disease.

According to survey results, 90% of responding providers knew of the program, and 40% referred it to at least half of their patients. Seventy percent of responders believed the class increased HCV knowledge, interest in treatment (52%) and patient-physician communication (56%).

“Formal HCV education by liver specialists creates efficiencies in resource-limited health care systems, which not only allows better access to specialty care and treatment services but also improves HCV antiviral effectiveness,” the researchers concluded. “ … interventions directed at increasing provider knowledge of HCV disease and the important role of patient education in improving HCV management will likely enhance HCV care coordination and ultimately amplify the success of antiviral therapy, particularly in vulnerable populations.”