Place of therapeutic patient education in chronic hepatitis C treated with direct-acting antivirals


Place of therapeutic patient education in chronic hepatitis C treated with direct-acting antivirals


Michel Doffoel1*, Simona Tripon1, Florence Ernwein1, Frédéric Chaffraix1, Lucile Haumesser2, Robert Bader3, Jean-Philippe Lang1, Anais Lang1, Dominique Paya4, Maude Royant1, Aurélie Velay-Rusch5, Martine Tebacher6, Nicolas Meyer2, François Habersetzer7, Thomas Baumert8

1Service expert de lutte contre les hépatites virales d’alsace (SELHVA) Pôle hépato-digestif, Nouvel hôpital civil, Hôpitaux universitaires, Strasbourg, France. 2Groupe méthode en recherche clinique, Pôle de santé publique au travail, Hôpitaux universitaires, Strasbourg, France. 3Service d’hépato gastroentérologie, Groupement hospitalier régional mulhouse sud alsace, Mulhouse, France. 4Pharmacie, Hôpitaux universitaires, Strasbourg, France. 5Laboratoire de Virologie, Hôpitaux universitaires, Strasbourg, France. 6Centre régional de pharmacovigilance, Hôpitaux universitaires, Strasbourg, France. 7Service d’hépato gastroentérologie, Pôle hépato-digestif, Nouvel hôpital civil, Hôpitaux universitaires, Strasbourg, France. 8Institut de recherche sur maladies virales et hépatiques, Inserm U1110, Université de Strasbourg, Strasbourg, France.


Objective: Today, with the availability of direct-acting antivirals (DAAs), the value of therapeutic patient education (TPE) in chronic hepatitis C needs to be redefined, as these drugs have made treatment simple. The study presented here in sought to define what role TPE plays today in hepatitis C management along with what factors are associated with such programs being used.

Methods: We included 786 patients mono-infected with hepatitis C virus (HCV) who underwent treatment with DAAs. 284 of whom benefited from a TPE program (36.1%). The characteristics of HCV and how it was treated were compared retrospectively between TPE+ and TPE- patients. The TPE program was overseen by a nurse.

Results: The following factors were associated with TPE on multivariate analysis: migrant status (OR=3.63, 95%CI: 2.24-5.96, p <0.001), advanced fibrosis (OR=1.73, 95%CI: 1.08-2.76, p=0.022), tobacco use (OR=1.84, 95%CI: 1.10-3.08, p=0.020) and pangenotypic DAA treatment (OR=0.42, 95%CI: 0.26-0.68, p <0.001). Sustained virological response at 12 weeks (SVR 12) was 96% in both groups.

Conclusion: Overall, TPE was primarily followed by migrants during their HCV management as part of overall medico-psycho-social care, and primarily those with severe disease.

Practice implication: TPE could help reduce the impact of social inequality on health.


Highlights

  • TPE in chronic hepatitis C treated with direct-acting antivirals need to be redefined.
  • The characteristics of chronic hepatitis C and how it is treated are compared between TPE+ and TPE- patients.
  • Migrant status, hepatic advanced fibrosis, tobacco use and pangenotypic direct-acting antivirals are associated with TPE.
  • Sustained virological response is high and do not differ between the 2 groups.

Keywords: hepatitis C, therapeutic patient education, direct-acting antivirals, migrants, advanced fibrosis, tobacco consumption

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How to cite this article:
Michel Doffoel, Simona Tripon, Florence Ernwein, Frédéric Chaffraix, Lucile Haumesser, Robert Bader, Jean-Philippe Lang, Anais Lang, Dominique Paya, Maude Royant, Aurélie Velay-Rusch, Martine Tebacher, Nicolas Meyer, François Habersetzer, Thomas Baumert.Place of therapeutic patient education in chronic hepatitis C treated with direct-acting antivirals.Open Journal of Gastroenterology and Hepatology, 2022, 5:60. DOI: 10.28933/ojgh-2021-11-2607


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