Proposed Solution, Implementation and Evaluation for Hepatitis C

I. Introduction.

The treatment for hepatitis C has undergone great improvements with new medicines and different methods of treatment. The drugs that are most commonly used to treat the disease are pegylated interferon and ribavirin, which have side-effects that often cause the patient to suffer from stress associated with the hepatitis C treatment. Because of these side effects and the related stress, many patients will want to discontinue their treatment. The purpose of this paper is to show that through the use of many positive management steps, a person that is having complications from hepatitis C treatments can have a more product life. The National Institute of Health has made it very clear that for the treatment to have better outcomes, the patient must seek support from family members, medical providers, friends and support groups.

Many patients have stated that by modifying their behavior, they can lessen the side-effects associated with hepatitis C treatments. There are many reasons patients want to modify their behavior, such as wanting to live longer, having a better quality of health, having a greater life expectancy, and experiencing the fullness of life and sharing those times with children and others. The number one reason patient’s want to cure themselves of the deadly virus hepatitis C diseases is so they do not develop cirrhosis of the liver, or cancer. Patients must have effective support systems in place to help them through the treatment process. This support can come from the providers who are giving them treatments, family and friends, but mainly from hepatitis C support groups.

II. Proposed Solution.

The side effects caused by the combination of interferon and ribavirin are difficult, although not impossible, for patients to manage. Patients may experience side effects relating to their (1) mental health, (2) whole body, (3) mouth, stomach and digestion, (4) skin and hair, or (5) general other side effects (“Side Effects Guide…,” n.d.). These symptoms will be managed through a prospective management program, through a coordinated effort with the patient, family members, care givers and other licensed health professionals (“Hepatitis C,” n.d.).

III. Implementation Plan.

Mental Health Side Effects. Many patients complain of symptoms of depression, difficulty sleeping or other mood-related disorders, such as anxiety or short-temperedness (“Side Effects Guide…,” n.d.). To address the psychological side effects from treatment, the patient will be referred for evaluation and possible on-going monitoring/counseling with a licensed health professional (“Hepatitis C,” n.d.). The patient will also be referred for prescription of an antidepressant (selective serotonin re-uptake inhibitor). The patient will speak with the treating physician if these symptoms get worse (“Hepatitis C,” n.d.).Whole Body Side Effects. Many patients complain of fatigue, as well as influenza-like symptoms (such as headaches, fever and muscle/body aches) (“Hepatitis C,” n.d.). To address the physiological side effects from treatment, the patient will implement a regular sleep schedule, including naps whenever possible. The patient will increase fluid intake to ensure proper hydration at all times. The patient will also take OTC acetaminophen or ibuprofen to alleviate other symptomatology (“Side Effects Guide…,” n.d.).

Mouth, Stomach and Digestion Side Effects

Many patients complain of poor appetite, bitter/metallic taste in their mouths, dry mouth/thick saliva, sore mouth/throat and nausea and vomiting or diarrhea (“Side Effects Guide…,” n.d.). To address these side effects from treatment, the patient will modify their diet regimen to include five or six smaller meals, instead of larger meals (including BRATT diet foods when nausea is present) (“Side Effects Guide…,” n.d.). Metallic tastes may be masked by eating tart foods (such as cranberries, pickles and vinegar). These patients should also avoid eating canned food or using metal utensils. Patients should also follow the hydration program recommended to alleviate other side effects (“Side Effects Guide…,” n.d.). Skin and Hair Side Effects. Many patients complain of hair loss and skin rashes. To address these side effects from antiviral therapy, patients should be counseled on caring for their hair during treatment, and avoid hair treatments. Patients may also use OTC body moisturizing lotions to alleviate skin disruptions. The patient may be referred for prescription of hydrocortisone cream, or other oral medications, if the symptoms do not improve (“Side Effects Guide…,” n.d.). Other General Side Effects. Patient may experience a host of other side effects related to treatment. The patient will address these issues, as they arise, with the treating physician (“Side Effects Guide…,” n.d.). The patient is encouraged to also communicate with friends and family members regarding any concerns regarding treatment. Patient is also encouraged to participate in a Hepatitis C support group to help manage the treatment regimen (“Managing Side Effects of Treatment,” n.d.).

IV. Evaluation Plan.

Mental Health Side Effects. The patient will be monitored by a licensed health professional for treatment of depression, or other mental health issues.Whole Body Side Effects. The patient will be monitored for anemia and hypothyroidism, using lab tests administered every one to two months. Patient will also be evaluated for infection if high fever persists for more than one day (“Side Effects Guide…,” n.d.). Mouth, Stomach and Digestion Side Effects.The patient will be evaluated for possible dehydration if presenting with complaints of vomiting or diarrhea (“Side Effects Guide…,” n.d.).Other Issues. The patient’s progress and response to treatment will also be monitored using lab tests administered every one to two months. Patient will also keep regular appointments with the treating physician (“Managing Side Effects of Treatment,” n.d.).

V. Conclusion.

With an effective support system and adequate treatment program, many patients make it through treatment for Hepatitis C with only minimal challenges. Patients should be counseled on the importance of follow up with their treating physician for up to 18 months after treatment to their progress. However, the patient should also be encouraged that they made it through treatment, and can now enjoy all of the things that made them undergo treatment in the first place.

References

Hepatitis C. (n.d.). Overview. NIAID. Retrieved from http://www.niaid.nih.gov/topics/hepatitis/hepatitisc/Pages/Default.aspx

Managing Side Effects of Treatment. (n.d.). Liver Foundation. Retrieved from http://hepc.liverfoundation.org/treatment/while-on-treatment/managing-side-effects/

Side Effects Guide: Entire Lesson. (n.d.). Side Effects Guide. Retrieved from http://www.hepatitis.va.gov/patient/treat/side-effects-single-page.asp