The patient-provider relationship is associated with hepatitis c treatment eligibility: A prospective mixed-methods cohort study

Rogal, SS and Arnold, RM and Chapko, M and Hanusa, BV and Youk, A and Switzer, GE and Sevick, MA and Bayliss, NK and Zook, CL and Chidi, A and Obrosky, DS and Zickmund, SL (2016) The patient-provider relationship is associated with hepatitis c treatment eligibility: A prospective mixed-methods cohort study. PLoS ONE, 11 (2).

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Abstract

Hepatitis C virus (HCV) treatment has the potential to cure the leading cause of cirrhosis and hepatocellular carcinoma. However, only those deemed eligible for treatment have the possibility of this cure. Therefore, understanding the determinants of HCV treatment eligibility is critical. Given that effective communication with and trust in healthcare providers significantly influences treatment eligibility decisions in other diseases, we aimed to understand patient-provider interactions in the HCV treatment eligibility process. This prospective cohort study was conducted in the VA Pittsburgh Healthcare System. Patients were recruited after referral for gastroenterology consultation for HCV treatment with interferon and ribavirin. Consented patients completed semi-structured interviews and validated measures of depression, substance and alcohol use, and HCV knowledge. Two coders analyzed the semi-structured interviews. Factors associated with patient eligibility for interferon-based therapy were assessed using multivariate logistic regression. Of 339 subjects included in this analysis, only 56 (16.5%) were deemed eligible for HCV therapy by gastroenterology (GI) providers. In the multivariate logistic regression, patients who were older (OR = 0.96, 95%CI = 0.92-0.99, p =.049), reported concerns about the GI provider (OR = 0.40, 95%CI = 0.10-0.87, p = 0.02) and had depression symptoms (OR = 0.32, 95%CI =0.17-0.63, p = 0.001) were less likely tobe eligible. Patients described barriers that included feeling stigmatized and poor provider interpersonal or communication skills. In conclusion, we found that patients' perceptions of the relationship with their GI providers were associated with treatment eligibility. Establishing trust and effective communication channels between patients and providers may lower barriers to potential HCV cure.

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Details

Item Type:	Article
Status:	Published
Creators/Authors:	Creators Email Pitt Username ORCID Rogal, SS ssr24@pitt.edu SSR24 Arnold, RM rabob@pitt.edu RABOB Chapko, M Hanusa, BV Youk, A ayouk@pitt.edu AYOUK Switzer, GE Sevick, MA Bayliss, NK nkb6@pitt.edu NKB6 Zook, CL clz10@pitt.edu CLZ10 Chidi, A apc10@pitt.edu APC10 Obrosky, DS Zickmund, SL slz9@pitt.edu SLZ9
Contributors:	Contribution Contributors Name Email Pitt Username ORCID Editor Lin, Wenyu UNSPECIFIED UNSPECIFIED UNSPECIFIED
Date:	1 February 2016
Date Type:	Publication
Access Restriction:	No restriction; Release the ETD for access worldwide immediately.
Journal or Publication Title:	PLoS ONE
Volume:	11
Number:	2
DOI or Unique Handle:	10.1371/journal.pone.0148596
Institution:	University of Pittsburgh
Schools and Programs:	School of Public Health > Biostatistics School of Medicine > Medicine School of Medicine > Surgery
Refereed:	Yes
Date Deposited:	23 Aug 2016 15:08
Last Modified:	02 Feb 2019 16:56
URI:	http://d-scholarship.pitt.edu/id/eprint/28303

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