“Fighting an uphill battle”: experience with the HCV triple therapy: a qualitative thematic analysis

BMC Infectious Diseases

Dunja Nicca⁴  Susi Saxer⁵  Jan Fehr⁶  Philip Bruggmann³  David Semela²  Patrick Schmid¹  Patrizia Künzler-Heule²  Manuela Rasi¹ 

[1] Cantonal Hospital St. Gallen, Division of Infectious Diseases and Hospital Epidemiology, 9007 St. Gallen, Switzerland;Cantonal Hospital St. Gallen, Division of Gastroenterology/Hepatology, 9007 St. Gallen, Switzerland;Arud Centres for Addiction Medicine, 8005 Zürich, Switzerland;Institute of Nursing Science, University of Basel, 4056 Basel, Switzerland;Institut of Applied Nursing IPW-FHS St. Gallen, University of Applied Science, 9000 St. Gallen, Switzerland;University of Zürich, 8006 Zürich, Switzerland

关键词: Self-management;    Protease inhibitor;    Hepatitis C;    Treatment experience;   

Others  :  1125538
DOI  :  10.1186/1471-2334-14-507

 received in 2014-02-14, accepted in 2014-09-10,  发布年份 2014

【 摘 要 】

Background

Hepatitis C virus (HCV) infections are a severe burden on public health worldwide, causing mortality rates triple that of the general population. Since 2011, for both therapy-naive and therapy-experienced genotype 1 patients, the first generation of direct acting antivirals (DAAs), i.e., the protease-inhibitors (PI) telaprevir and boceprevir have been added to existing dual therapies. The therapeutic effect of the resulting triple therapy is striking; however, treatment regimens are complex and commonly cause side effects. Little is known of how patients implement therapy in their daily lives, or of how they deal with these effects.

This study aims to describe HCV patients' experiences with protease-inhibitor-based triple therapy and their support needs.

Methods

A qualitative design was used. Patients from three outpatient clinics, with ongoing, completed or discontinued PI treatment experience were recruited using a maximum variation sampling approach. Open-ended interviews were conducted and analyzed using thematic analysis according to Braun & Clarke (Qual Res Psychol 3:77-101, 2006).

Results

Thirteen patients participated in the interviews. All described themselves as highly motivated to undergo treatment, since they saw the new therapy as a “real chance” for a cure. However, all later described the therapy period as a struggle. The constitutive theme–“Fighting an uphill battle”– describes the common existential experience of and negative consequences of coping with side effects. The processes that fostered this common experience followed three sub-themes: “encountering surprises”, “dealing with disruption” and “reaching the limits of systems”.

Conclusion

HCV patients undergoing outpatient protease-inhibitor-based triple therapy need systematic support in symptom management. This will require specially trained professionals to advise and support them and their families, and to provide rapid responses to their needs throughout this complex course of therapy. As the generation of DAAs for all genotypes, are expected to have less severe side effects, and many HCV patients require treatment, this knowledge can improve treatment support tremendously, especially for patients who are quite difficult to treat. Furthermore, these findings are helpful to illustrate development in HCV treatment.

【 授权许可】

   
2014 Rasi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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