hepatitis c self-management

Conditions: Hepatitis C; Chronic Disease

Summary: the objective of this study is to compare the efficacy of a 6-session hepatitis c self-management workshop to a hepatitis c self-management self-study program. both interventions are designed to help people with hepatitis c learn to actively self-manage their chronic hcv infection, and ultimately, to improve health outcomes for veterans with hcv who are not receiving interferon-based treatment. participants complete a total of four assessments. the fourth assessment, a 12-18 month assessment is an approved addition to the original study design

background: chronic hepatitis c (hcv) is a major health concern that disproportionately affects u.s. veterans. veterans with hcv experience impaired quality of life as a result of hcv infection and other co-morbid disorders; namely substance abuse and mental health problems. only a small proportion of these patients currently receive and are cured of hcv with interferon-based treatments. treatment recommendations for hcv-infected veterans not scheduled for interferon-based treatment include additional evaluations/procedures and adherence to behavioral/lifestyle guidelines. however, many patients with hcv and commonly occurring co-morbidities have difficulty following these recommendations without additional assistance. hcv self-management programs are one option for helping these patients adhere to treatment recommendations while improving their quality of life. patient self-management programs augment traditional information-oriented patient education with problem-solving skills and cognitive-behavioral techniques that enable patients to manage chronic illness and their lives as a whole. objectives: our primary objective was to assess the efficacy of a 6-session self-management workshop designed to improve health outcomes for veterans with hcv who are not receiving interferon-based treatment. methods: one hundred- thirty seven veterans with hcv who receive health care at va san diego healthcare system facilities were randomized to either the hcv self-management workshop (hcv-smw) or to the information intervention study arm. the self-management intervention includes six 2.5-hour weekly workshop sessions in addition to the basic information provided to usual care. the hcv-smw was co-led by a health educator and a peer-leader, and has been adapted from an existing self-management program that has been effective for patients with other chronic illnesses. the primary outcome for the study is health-related quality of life. secondary outcome variables include attendance at recommended health care visits, self-reported health behaviors related to preventing viral transmission, substance use/abuse, and patient-provider communication. data was collected at baseline, end-of-intervention (6 weeks), at a 12-month and 18-month follow-up visits using self-report questionnaires. in accordance with hipaa guidelines, va medical records and other databases were accessed to gather data on health care utilization and mortality. data was analyzed using repeated-measures analysis of variance, ancova, and linear mixed-model approaches. in addition, an exploratory cost analysis will be conducted when final analyses are conducted. status: the study was completed in 2011. results have been published and citations are provided on this website. an additional manuscript including a cost-effectiveness analysis is in the process of being published.

Eligibility criteria:
inclusion criteria: * va patient * diagnosis of chronic hepatitis c viral infection exclusion criteria: * undergoing treatment with interferon and/or ribavirin currently or within 6 months of enrollment * inability to confirm hcv diagnosis

Keywords: self-care quality of life chronic disease