J HEPATOL:多学科支持计划提高慢性丙肝患者依从性及抗病毒治疗有效性

2013-07-11 陈郁婷 dxy

对于慢性丙型肝炎(CHC)患者来说,坚持抗病毒治疗对于获得持续病毒学应答(SVR)是非常重要的。因此,来自西班牙Hospital del Mar医院肠胃病学部门的José A. Carrión博士及其同事展开一项研究,旨在评估了一项多学科支持计划(MSP)对于提高CHC病患依从性和增加聚乙二醇干扰素α-2a和利巴韦林治疗有效性的作用,该计划以已发表的HIV治疗经验为依据。该研究结果在线发表于201

对于慢性丙型肝炎(CHC)患者来说,坚持抗病毒治疗对于获得持续病毒学应答(SVR)是非常重要的。因此,来自西班牙Hospital del Mar医院肠胃病学部门的José A. Carrión博士及其同事展开一项研究,旨在评估了一项多学科支持计划(MSP)对于提高CHC病患依从性和增加聚乙二醇干扰素α-2a和利巴韦林治疗有效性的作用,该计划以已发表的HIV治疗经验为依据。

该研究结果在线发表于2013年6月27日的《肝脏病学杂志》(Journal of Hepatology),作者发现,MSP可提高病患依从性并增强CHC抗病毒治疗有效性,是一项经济有效、符合成本效益的计划。
研究人员将447名接受抗病毒治疗的患者分为3组:对照组(2003-2004,n=147),MSP组(2005-2006,n=131)和MSP验证组(2007-2009,n=169)。MSP组配备有两名肝病医生、两名护士、一名药剂师、一名心理医生、一名行政助理和一名精神病医生。并最终采用Markov模型进行成本效益分析。

研究结果如下:相比于对照组(78.9%,61.9%),MSP组(94.6%,77.1%)和MSP验证组(91.7%,74.6%)的病患依从率和SVR率更高(p<0.05)。MSP组的基因1型或4型SVR率高于对照组(67.7% vs. 48.9%,p=0.02),相比之下,两个组别的基因2型或3型SVR率相当(87.7% vs. 81.4%,p=ns)。对于感染基因1型HCV的患者来说,MSP是SVR的主要预测因素。对于患有精神疾病的患者,MSP组(n=95,90.5%)的依从率高于对照组(n=28,75.7%)(p= 0.02)。

此外,MSP组每例患者的成本为€ 13,319(欧元),而对照组为€ 16,184(欧元)。对于所有的HCV基因型来说,MSP组患者(16.317 QALYs)所获得的生活质量调整年(QALYs)均多于对照组(15.814 QALYs)。研究发现,MSP可提高病患依从性并增强CHC抗病毒治疗的有效性,这是一项经济有效、符合成本效益的计划。


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    2013-07-13 yahu
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    2013-07-13 fyxzlh
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    2013-07-13 gwc384
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