Acceptability of Psychotherapy, Pharmacotherapy, and Self-Directed Therapies in Australians Living with Chronic Hepatiti
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Acceptability of Psychotherapy, Pharmacotherapy, and Self-Directed Therapies in Australians Living with Chronic Hepatitis C Benjamin J. R. Stewart • Deborah Turnbull • Antonina A. Mikocka-Walus • Hugh A. J. Harley Jane M. Andrews
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Ó Springer Science+Business Media New York 2013
Abstract Despite the prevalence of psychiatric co-morbidity in chronic hepatitis C (CHC), treatment is under-researched. Patient preferences are likely to affect treatment uptake, adherence, and success. Thus, the acceptability of psychological supports was explored. A postal survey of Australian CHC outpatients of the Royal Adelaide Hospital and online survey of Australians living with CHC was conducted, assessing demographic and disease-related variables, psychosocial characteristics, past experience with psychological support, and psychological support acceptability. The final sample of 156 patients (58 % male) had significantly worse depression, anxiety, stress, and social support than norms. The most acceptable
support type was individual psychotherapy (83 %), followed by bibliotherapy (61 %), pharmacotherapy (56 %), online therapy (45 %), and group psychotherapy (37 %). The most prominent predictor of support acceptability was satisfaction with past use. While individual psychotherapy acceptability was encouragingly high, potentially less costly modalities including group psychotherapy or online therapy may be hampered by low acceptability, the reasons for which need to be further explored. Keywords Hepatitis C Acceptability Mental health Psychotherapy Pharmacotherapy
Introduction B. J. R. Stewart (&) D. Turnbull A. A. Mikocka-Walus School of Psychology, University of Adelaide, North Terrace, Adelaide, SA 5005, Australia e-mail: [email protected] D. Turnbull e-mail: [email protected] A. A. Mikocka-Walus e-mail: [email protected] A. A. Mikocka-Walus School of Nursing and Midwifery, University of South Australia, North Terrace, Adelaide, SA 5001, Australia H. A. J. Harley J. M. Andrews Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5001, Australia e-mail: [email protected] J. M. Andrews e-mail: [email protected] H. A. J. Harley J. M. Andrews Discipline of Medicine, University of Adelaide, Adelaide, Australia
A Brief Background to Chronic Hepatitis C The hepatitis C virus (HCV) is a blood-borne virus affecting the liver. Of those exposed to HCV, approximately 15–25 % spontaneously clear the virus within 6 months, while the remainder experience chronic hepatitis C (CHC) infection (Thomas & Seeff, 2005). CHC is estimated to affect approximately 221,000 Australians, comprising around 1 % of the population (The Kirby Institute, 2011). Comparatively, CHC is estimated to affect around 5.4 million (1.8 %) people in the USA and 160 million (2.4 %) globally (Lavanchy, 2011). Over a number of decades, between 15 and 20 % of those infected may progress to end-stage liver disease (Liang, Rehermann, Seeff
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