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BACKGROUND/RATIONALE:
Hepatitis C is a major health problem in the VHA. Effective antiviral treatment is available, but it is often poorly tolerated. Treatment completion rates are low. Little is known about the factors that facilitate or impede treatment completion.
OBJECTIVE(S):
Objective(s): The proposed study will consist of two focused, well-defined qualitative examinations of VHA patients experiences with HCV treatment. Semi-structured, open-ended, in-depth interviews will be conducted with two different groups of patients: those who have recently completed HCV treatment and those who have recently withdrawn from HCV treatment. Patients accounts of their experiences will be analyzed in order to specify empirically a model of treatment adherence/completion to guide subsequent research. Specifically, we will:
1.Identify attributes of the experience of undergoing treatment for HCV that patients perceive and associate with either completing or withdrawing from treatment
2.Develop an empirically grounded adaptation of the Information-Motivation-Behavioral Skills (IMB) Model of patients completion of HCV treatment in the VHA.
METHODS:
Research Design: The proposed study will include in-depth, qualitative interviews with two very different groups of patients: 1) those who completed HCV treatment, and 2) those who terminated treatment prematurely. We expect substantial between-group differences in the stories these patients will tell, as well as substantial within-group differences among those who completed treatment with and without sustained viral response SVR. We also expect that systematic comparison of patients accounts, both within and between groups, will highlight aspects of IMB theory and their social context that may account for treatment completion or premature termination. By including completers who do and do not achieve SVR, we can address the likely effects of realizing a difficult therapeutic goal on how patients reconstruct their experiences.
Methodology: Our sample will include nine patients who have completed HCV treatment in the past year and nine patients who terminated treatment prematurely in the past year. The interviews will be conducted using semi-structured protocols. The audio-tapes of the interviews will be transcribed verbatim for analysis as word processing text files that may be manipulated by a qualitative software program. Analysis will follow the general procedures of grounded theory methodology. We will examine patients accounts to identify themes pertaining to the major categories of the conceptual model, as well as other major themes. Particular attention will be paid to linkages articulated between conceptual categories. We will look for patients constructions of sequential relationships and attributions of cause and effect that explain their actions relative to completing treatment.
FINDINGS/RESULTS:
No findings to date.
IMPACT:
Not yet applicable.
PUBLICATIONS:
None at this time.
DRA:
Chronic Diseases
DRE:
Communication and Decision Making, Diagnosis and Prognosis, Treatment
Keywords:
Patient preferences, Adherence, Hepatitis C
MeSH Terms:
none
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