A multidisciplinary support programme increases the efficiency of ...

Research Article

A multidisciplinary support programme increases the efficiency of pegylated interferon alfa-2a and ribavirin in hepatitis C José Antonio Carrión1,⇑, Elena Gonzalez-Colominas2, Montserrat García-Retortillo1, Nuria Cañete1, Isabel Cirera1, Susanna Coll1, Maria Dolors Giménez1, Carmen Márquez1, Victoria Martin-Escudero3, Pere Castellví1,4, Ricard Navinés4,5, Juan Ramon Castaño5, Josep Anton Galeras1, Esther Salas2, Felipe Bory1, Rocío Martín-Santos4,5, Ricard Solà1 1

Liver Section, Gastroenterology Department, Hospital del Mar, Universitat Autònoma de Barcelona, IMIM (Institut Hospital del Mar d’Investigacions Mèdiques), Barcelona, Spain; 2Pharmacy Department, Hospital del Mar, Universitat Autònoma de Barcelona, Spain; 3 Roche Pharma, Madrid, Spain; 4Departments of Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic, Universitat de Barcelona, IDIBAPS, CIBERSAM, Spain; 5Psychiatry Department, Hospital del Mar and Neuropsychopharmacology Programme, IMIM-Hospital del Mar, Spain

Background & Aims: Adherence to antiviral treatment is important to achieve sustained virological response (SVR) in chronic hepatitis C (CHC). We evaluated the efficiency of a multidisciplinary support programme (MSP), based on published HIV treatment experience, to increase patient adherence and the efficacy of pegylated interferon alfa-2a and ribavirin in CHC. Methods: 447 patients receiving antiviral treatment were distributed into 3 groups: control group (2003–2004, n = 147), MSP group (2005–2006, n = 131), and MSP-validation group (2007–2009, n = 169). The MSP group included two hepatologists, two nurses, one pharmacist, one psychologist, one administrative assistant, and one psychiatrist. Cost-effectiveness analysis was performed using a Markov model. Results: Adherence and SVR rates were higher in the MSP (94.6% and 77.1%) and MSP-validation (91.7% and 74.6%) groups compared to controls (78.9% and 61.9%) (p