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News

Meaning of 'cure' in Hep C therapy

April's Journal of Clinical Gastroenterology examines how Physicians describe outcomes and the meaning of 'cure' during provider-patient in-office discussions of HCV.

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How physicians convey information about Hepatitis C virus impacts patients' perceptions of treatment outcomes and informed therapy decisions.

Hepatitis C virus patients reported difficulties communicating with their physicians in a recent study.

70% of response-related utterances were framed optimistically
Journal of Clinical Gastroenterology

Another study showed that 45% of patients did not understand projected response rates conveyed by providers.

Patients with unfavorable projected treatment outcomes were more likely to lack understanding.

Dr Heidi Hamilton and colleagues analyzed naturally occurring patient-provider interactions to evaluate physicians' use of the word cure.

The team framed Hepatitis C virus response as optimistic, pessimistic, or neutral, to suggest possible reasons why patients with unfavorable projected sustained virologic response rates might perceive their odds as more favorable than they are.

The team video and audio-recorded gastroenterologists, allied health professionals, and Hepatitis C virus patients during regular scheduled visits.

Recordings were transcribed and analyzed using validated sociolinguistic techniques.

The researchers found that 63% of physicians used the word cure in 38% of visits involving response discussions.

Cure most frequently meant absolute cure and occurred more commonly in visits conducted before therapy initiation, and with patients having favorable genotypes.

Physicians hedged the meaning of cure in 29% of visits.

The research team noted that 70% of response-related utterances were framed optimistically.

Dr Hamilton‘s team concluded, "Hepatitis C virus dialogs are characterized by the prevalence of cure and optimistic framing."

"These positive language attributes could potentially contribute to the misunderstanding regarding the projected response rates."

"During treatment outcome discussions, the physicians should attempt to operate using the same definition of the therapy outcome as the patient.

"The physicians should also balance medically accurate information with patient comprehension."

"In addition, possible consequences of discussing treatment options on the basis of message framing should be considered."

J Clin Gastroenterol 2008: 42(4): 419-24
31 March 2008

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