临床结果和患者报告的HCV护理措施:来自意大利一个大地区的纵向前性研究的见解
Giaele Moretti1, Maria Paola Tramonti Fantozzi2, Ilaria Corazza1
1Management and Healthcare Laboratory, Institute of Management and Department EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy.
PloS one
|March 11, 2026
概括
直接作用抗病毒药物 (DAA) 有效治疗C型肝炎病毒 (HCV) 感染,实现高持续病毒学反应 (SVR12) 率. 整合患者报告的结果 (PROM) 和经验 (PREM) 对于改善护理公平性和以患者为中心的HCV消除策略至关重要.
科学领域:
- 肝病学和病毒性胃肠病学
- 公共卫生和流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 型肝炎病毒 (HCV) 感染是一个全球性的健康问题,直接作用抗病毒药物 (DAA) 改变了治疗.
- 在现实世界中,消除HCV在诊断,获得护理和随访方面面临着挑战.
- 整合患者报告结果指标 (PROM) 和患者报告体验指标 (PREM) 可以提高医疗保健服务的提供.
研究的目的:
- 评估意大利托斯卡纳的HCV护理级联中的临床和患者报告结果.
- 评估卫生服务组织如何影响HCV护理的有效性,公平性和患者体验.
- 确定差异,并为高风险人群提供量身定制的方法.
主要方法:
- 这是一项多中心前性研究,涉及953名患有慢性HCV感染的成年人,他们在2021-2023年期间接受治疗.
- 在多个时间点收集临床数据 (人口统计,并发病,纤维化,SVR12,随访损失) 和PROM/PREM (SF-12,定制调查).
- 根据转诊来源 (全科医生,减伤/监狱,专家) 对患者进行分层分类,并分析临床和问卷数据.
主要成果:
- DAA治疗显示出高临床疗效,SVR12率为93.4% (98.6%不包括随访损失).
- 在治疗后,PROMs在身体和情绪健康方面显著改善,特别是在全科医生和专家推的患者中.
- 推途径影响了患者的个人资料和结果,揭示了经验和生活质量的差异.
结论:
- 整合临床和患者报告的数据对于监测HCV护理的有效性和公平性至关重要.
- 高SVR率证实了DAA的有效性,而PROM/PREM则提供了对患者参与度的见解.
- 针对不同的护理途径,特别是高风险群体,需要量身定制的策略,以推进HCV消除.
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