We read with great interest the article by Szeinbach et al. in which the development of the chronic hepatitis C virus (HCV) treatment satisfaction (HCVTSat) instrument is described.1 There is a high prevalence of depression and anxiety in HCV, and this depression is accompanied by an increased risk of adverse experience with illness. Interferon-based therapy can add substantially to this mental health burden, which compounds the pre-existing effect of HCV on quality of life including fear of the disease or effects of treatment as well as socio-economic ramifications.3, 4 While instruments to assess 'functional status' during and following HCV treatment exist, there remains a need to develop and validate patient-centred surveys focused on quality of life, expectations and experienced or perceived issues with HCV therapy. Assessing satisfaction might bridge gaps to earlier adoption of treatment by patients, instead of waiting for the development of cirrhosis which can occur in 20% of patients.
5The questionnaire used has been developed from the patient's perspective, and focuses on HCV therapy perception using valid techniques. These types of tools are necessary for forming a therapeutic alliance between patient and clinician by fostering understanding of patient-related concerns. The 10-question instrument, however, was based on predominantly Caucasian, tertiary-care patients, three-quarters of whom were insured. Furthermore, only 21% of patients were undergoing treatment, and influence of HCV genotype was not studied.As a result, further work is needed to make this truly representative of the current HCV patient population. However, this paper introduces a relatively easy method to measure patient-perceived treatment satisfaction in HCV. As options for treatment evolve, especially in the era of direct-acting anti-virals, patient-centred instruments will be important to understand the factors involved in influencing therapy selection, and may potentially prevent therapy dropouts.
ACKNOWLEDGEMENTDeclaration of personal and funding interests: None.