The Effectiveness of Telephone Counseling on Treatment-Related Symptoms and Health-Related Quality of Life (HRQOL) in Patients with Chronic Hepatitis C Undergoing Oral Direct Acting Antiviral Non-interferon-based Treatment

Written by Natalia Watkins

doi: https://doi.org/10.13178/jnparr.2020.10.01.1006

Abstract

Background: Hepatitis C, a viral borne disease that affects between three to four million people in the United States, can be life-threatening, progressing to chronic hepatitis C (CHC), cirrhosis, or liver cancer. New treatments, such as oral, Direct Acting Antiviral (DAA) non-interferon based (non-INF) treatments can positively address symptoms and even cure CHC, but they can also lead to their own untoward side-effects that can affect
patients’ health related quality of life (HRQOL). Telephone counseling, shown to assist patients with chronic illnesses to manage their symptoms, may help patients undergoing oral DAA non-INF treatments for CHC and improve their quality of life.

Objective: This project explored the relationship with telephone counseling, treatment-related symptoms, and HRQOL among patients with CHC taking oral, DAA non-INF treatment before, during, and after receiving treatment.

Methods: Data from the SF-36 survey were collected and analyzed using the Statistical Package of Social Sciences (SPSS). A t-test was used to compare data from the first administered SF 36 with the second, which showed a comparison of HRQOL at the beginning and end of the study, that is, before and after telephone counseling. Data collected from an author-constructed survey that ascertained treatment-related symptoms were individually assessed before, during, and after completion of the regimen treatment. Non-parametric Friedman’s ANOVA procedures were conducted to determine whether symptom severity changed across time, using mean ranks.

Results: The sample experienced mild symptoms, such as, fatigue and bodily pain before, during, and after treatment, as shown by mean scores from Friedman’s ANOVA between zero and 1.57. Before and during treatment, the symptom with the highest mean score was fatigue, 1.29 and 1.57 respectively. At the end of treatment, the mean score was .86. To determine whether functioning changed after treatment, statistical significance of paired t-tests showed that bodily pain scores improved significantly, t(6) = -1.99, p = .046. The mean bodily pain score after the telephone intervention (M = 71.00, SD = 9.40) was significantly higher than the mean bodily pain score prior to the intervention (M = 53.57, SD = 20.63).

Conclusion: Reduction in symptoms of fatigue and bodily pain at the end of treatment showed that telephone counseling had a positive influence on symptoms management and improvement, which promotes participants’ improved HRQOL.

Keywords: telephone counseling, hepatitis C, non-INF treatment, health-related quality of life, direct acting antiviral medication, HRQOL