[In chronic hepatitis C, delays between diagnosis and treatment are linked to the doctor-patient relationship]
Tous les auteurs :
Enel C, Minello A, Jooste V, Pinoit JM, Hillon P
An epidemiological survey conducted in Cote d'Or and Doubs in 2004 showed that out of 1,251 patients carrying HCV, only 1 in 4 was treated whereas 1 in 6 evades medical care after diagnosis. A study carried out in Burgundy in 2006-2008 aimed to identify the key factors underlying insufficiency in medical care of hepatitis C. Semi-structured in-depth interviews were conducted with 25 medical doctors. They covered the frequency with which doctors were confronted with hepatitis C and the difficulties encountered in its management. The interviews with patients explored the circumstances of diagnosis, therapeutic route, perceptions regarding infection and its treatment and relationships with healthcare providers. The study showed a variability in delays between diagnosis and treatment that can be explained by the functioning of the doctor-patient relationship, and the choices of medical strategies. To prevent more efficiently hepatitis C complications, treatment acceptance by patients needs to be improved and doctors' hesitations in prescribing it lessened. Efforts should also be made to reduce the iatrogenic side effects of the treatment, and improve general practitioners' training with respect to viral hepatitis, and interaction between the medical specialities involved, in order to develop greater consensus in therapeutic strategies to be adopted.
Med Sci (Paris). 2009 May;25(5):519-23.