抄録
Hepatitis C virus (HCV) is a leading cause of liver disease in Japan. Standard care of pegylated-interferon alfa as monotherapy and in combination with oral ribavirin has been used for the treatment of chronic hepatitis C in outpatient clinics. However, such treatments are associated with patients'anxiety concerning high medical costs, adverse events, the burden of weekly hospital visits, the impact on attendance at work, and the eventual outcome of treatment.In this study, we investigated the impact on patients when a pharmacist-managed education program about interferon therapy was provided prior to their final acceptance of treatment. Educational intervention significantly reduced patients' anxiety about medical costs (p=0.004), adverse events (p=0.001) and impact on work (p=0.002). Patients in both the treatment group and the no-treatment group rated each section of the education program as being necessary. The patients expected answers regarding their personal concerns about the treatment. They thought it necessary that information such as that regarding severe adverse events should be explained by a pharmacist.Moreover, the sustained virological response rate differed significantly between the educated group and the group not educated by the pharmacist. Adherence to the recommended doses of the drugs during the initial period (first 12 weeks) of treatment is important for the efficacy of pegylated-interferon therapy. The educational intervention prior to the treatment may have raised the SVR rate. Also, a single session of the pharmacist-initiative education may be expected to compensate for the shortage of physicians and be cost effective.
