Patient’s preferences for health scenarios associated with hepatitis C and its treatment

Abstract

Antiviral therapy with peg-interferon and ribavirin induces sustained virus eradication in 40%-80% of patients with chronic hepatitis C virus (HCV). We investigated patient views on their involvement in therapeutic decision making and on the desirability of disease and treatment-related outcomes. The control preferences and visual analog scales were administered in a pencil and paper format to a series of 45 patients in order to assess their decisional role, preferences for scenarios of HCV disease and antiviral treatment, and estimates of success required to recommend treatment. The preferred decisional role of patients was passive in 26 (58%), collaborative in 12 (27%) and active in 7 (15%). Median preference scores ranged from 0.30 to 0.90 for scenarios of disease, from 0.05 to 0.80 for side effects and from 25% to 100% for estimates of benefit to recommend treatment. Our patients prefer to defer to the doctor the final decision in starting therapy in a context of shared decision making. Reported preferences for HCV scenarios are in the range discussed in the literature. The wide variability in the values attributed to side effects by patients with chronic hepatitis C as well as in expected probabilities of successful treatment suggests a need for decision analysis tailored to the individual patient.