The Meaning Of Adherence Among Veterans Receiving Pegylated Interferon And Ribavirin Antiviral Treatment For Chronic Hepatitis C

Abstract

The purpose of this study was to describe the meaning of adherence and adherence experiences in hepatitis C (HCV) infected Veterans receiving pegylated interferon and ribavirin antiviral treatment. In addition, how these experiences influenced the Veteran‟s choice to remain adherent or non-adherent was vital to the concept of adherence. The theoretical framework used to guide this project was the Information, Motivation and Behavioral Skills Model of Adherence.A convenience sample of 21 HCV infected Veterans who were enrolled in a VA HCV treatment clinic were recruited. Those who were receiving antiviral treatment or who had recently completed antiviral treatment were eligible to participate. The researcher conducted a one-time interview with each participant using open-ended questions. The interviews were audio-recorded and transcribed verbatim. Demographic information was collected and a brief telephone conversation followed to ensure the accuracy of each transcript. Data analysis included data immersion, transformation, and reduction, and the hermeneutic circle.The following themes emerged from the transcripts, including commitment to the cure, to the treatment, to the healthcare provider and to the discipline necessary to sustain the treatment. The Veterans expressed that they were not ready to leave this world, and were inclined to make healthy lifestyle changes. The Veterans applied the notion of unfinished business to antiviral treatment in that, they were able to clean up their past mistakes. Also influencing adherence was the family, manner of coping, and disclosure. The recovery phase was described as a time of hope.This phenomenological study uncovered several themes that have implications for clinical practice. The themes indicated that HCV infected Veterans may benefit from interventions that streamline patient education, and promote social support. A holistic, case management approach to patient care may be advantageous for the Veteran and may enhance adherence during antiviral treatment.