The hepatitis C self‐management programme: a randomized controlled trial

Abstract

Chronic hepatitis C (HCV) infection afflicts millions of people worldwide. While antiviral treatments are effective for some patients, many either cannot or choose not to receive antiviral treatment. Education about behavioural changes like alcohol avoidance and symptom management, in contrast, is universally recommended, particularly in HCV-infected persons from disadvantaged groups where liver risk factors are most prevalent. Self-management interventions are one option for fostering improved HCV knowledge and health-related quality of life (HRQOL). One hundred and thirty-two patients with VA with HCV (mean age of 54.6, 95% men, 41% ethnic minority, 83% unmarried, 72% unemployed/disabled, 48% homeless in last 5 years) were randomized to either a 6-week self-management workshop or an information-only intervention. The weekly 2-h self-management sessions were based on cognitive-behavioural principles and were adapted from an existing self-management programme that has been efficacious with other chronic diseases. HCV-specific modules were added. Outcomes including HRQOL, HCV knowledge, self-efficacy, depression, energy and health distress were measured at baseline and 6 weeks later. Data were analysed using ANOVA. When compared to the information-only group, participants attending the self-management workshop improved more on HCV knowledge (P < 0.001), HCV self-efficacy (P = 0.011), and SF-36 energy/vitality (P = 0.040). Similar trends were found for SF-36 physical functioning (P = 0.055) and health distress (P = 0.055). Attending the self-management programme improved disease knowledge and HRQOL 6 weeks later in this disadvantaged population. The intervention can improve the health of people with hepatitis C, independent of antiviral therapy. Future research will study longer-term outcomes, effects on antiviral treatment and costs.

Reliability and validity of a self‐efficacy instrument for hepatitis C antiviral treatment regimens

“…Self‐efficacy beliefs are important targets for clinical intervention, given that they can be enhanced, resulting in improved patient self‐management of chronic illness, including chronic hepatitis C [35,36]. However, self‐efficacy requires measurement precision specific to the [1] behaviour being studied (e.g.…”

“…Despite the importance of self‐efficacy to medication adherence in other medical regimens, there is limited research in the HCV literature that examines self‐efficacy beliefs, and no studies were identified that examined these beliefs during antiviral treatment [35,36]. A self‐efficacy measure was included in the NIH‐funded study, Viral Resistance to Antiviral Therapy of Chronic Hepatitis C (VIRAHEP‐C) study.…”

Chronic hepatitis C and antiviral treatment regimens: Where can psychology contribute?

“…Given that patients experience preexisting clusters of somatic/neurovegetative symptoms in the early weeks of treatment (e.g., fatigue, insomnia, pain, headache) that lead to reduced HrQOL and worsening depression later in treatment, multi-component psychological interventions that treat multiple concurrent symptoms and improve overall coping skills may be highly beneficial. Empirically-proven psychological treatments for other disease symptoms and treatment side effects exist and can be adapted for HCV treatment (Andersen et al, 2004; Antoni, Ironson, & Schneiderman, 2007; Given et al, 2004; Groessl et al, 2011; Safren et al, 2009). …”

Novel Interventions for HIV Self-management in African American Women: A Systematic Review of mHealth Interventions

“…Adherence to standardized HIV care and treatment regimens is essential to achieve optimal health outcomes. Nonetheless, public health officials estimate only one fourth of Americans who are living with HIV are successfully managing virus-related sequelae (Hall et al, 2013), which is disheartening given that self-management of other chronic conditions has been associated with better health outcomes (Barlow, Wright, Sheasby, Turner, & Hainsworth, 2002;Groessl et al, 2011;Lorig, Ritter, Laurent, & Plant, 2006;Ory et al, 2013).…”