Journal of the Formosan Medical Association = Taiwan yi zhi · 2026
Physicians, case managers, and HCV patients recommend a simplified strategy for baseline testing and minimal monitoring for treatment of hepatitis C virus infection with DAA therapies.
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Liu Chun-Jen, Lin Hsin-Jung, Lin David, Kwon Kyung Min, Chen Linda
Аннотация
OBJECTIVES: In Taiwan, comprehensive pretreatment assessments and laboratory monitoring visits are required for patients receiving National Health Insurance Administration-reimbursed direct-acting antiviral (DAA) treatment, with results reported via the virtual private network (VPN) registration system. The study aims to gather opinions on a simplified DAA treatment strategy, assess its feasibility, and understand the burden of HCV treatment adherence.
METHODS: A non-interventional prospective survey study was conducted from October 17 to December 20, 2022. A total of 100 HCV patients, 50 physicians, and 20 case managers participated via a hybrid survey. Patients were grouped into comorbidity, special populations, and others (3:1:1). Factors influencing adherence to a simplified DAA treatment strategy versus current NHIA requirements were analyzed.
RESULTS: Fifteen percent of patients declined treatment, and 15 % experienced interruptions. Key barriers included low perceived disease severity (47 %), concerns about treatment effectiveness (40 %) and logistical challenges. Physician and case managers cited poor physical performance (46 %, 55 %) and treatment intolerance (42 %, 50 %) as major medical reasons for discontinuation. The COVID-19 pandemic disrupted care for 16 % of physician-reported and 35 % of case manager reported cases. Additionally, 58 % of physicians and 40 % of case managers found the VPN system overly complex or unnecessary.
CONCLUSIONS: Educating patients on HCV treatment benefits is crucial for improving adherence. Individualized monitoring, streamlined VPN requirements and expanded telemedicine use may reduce treatment burden and enhance long-term success.
METHODS: A non-interventional prospective survey study was conducted from October 17 to December 20, 2022. A total of 100 HCV patients, 50 physicians, and 20 case managers participated via a hybrid survey. Patients were grouped into comorbidity, special populations, and others (3:1:1). Factors influencing adherence to a simplified DAA treatment strategy versus current NHIA requirements were analyzed.
RESULTS: Fifteen percent of patients declined treatment, and 15 % experienced interruptions. Key barriers included low perceived disease severity (47 %), concerns about treatment effectiveness (40 %) and logistical challenges. Physician and case managers cited poor physical performance (46 %, 55 %) and treatment intolerance (42 %, 50 %) as major medical reasons for discontinuation. The COVID-19 pandemic disrupted care for 16 % of physician-reported and 35 % of case manager reported cases. Additionally, 58 % of physicians and 40 % of case managers found the VPN system overly complex or unnecessary.
CONCLUSIONS: Educating patients on HCV treatment benefits is crucial for improving adherence. Individualized monitoring, streamlined VPN requirements and expanded telemedicine use may reduce treatment burden and enhance long-term success.