Psychoeducation for HCV and Alcohol Behaviors

丙型肝炎（HCV）的医学治疗需要坚定的坚持才能有效，但身体和健康

Medical treatment of hepatitis C (HCV) requires steadfast adherence to be effective, yet physical and psychiatric side effects induced by current medications (interferon and ribavirin) undermine patient motivation and consistency. Barriers to this population's access to vital services, including transportation and insurance and lack of stable housing, pose further threats to optimal management of HCV. Promotion of adherence and patient support may be enhanced if family members and significant others can be enlisted to join HCV providers in this effort. Psychoeducation programs, demonstrated by this team to be effective for patients and families coping with serious mental illness, can have direct relevance and application to HCV. The proposed project will apply a unique, effective family-responsive psychoeducation program (PERF) for HCV, which has not been previously attempted in this population. HCV-PERF will be compared with a didactic education intervention in a randomized controlled trial with 400 HCV patients. The goal is to demonstrate that the intervention will enlarge the eligibility of some patients for HCV treatment and help sustain others through it. The program will provide HCV education and a forum to discuss problems in daily living and coping with the illness in a supportive, proactive, and problem-focused agenda. The topics and issues covered in the psychoeducation groups will emerge from expressed interests of the group members, generating participant-specific discussions emphasizing and reinforcing personalized solutions to the problems of living with a chronic illness and its difficult treatment regimen. This intervention will build on the skills of HCV and mental health professionals with two professionals, one with HCV treatment expertise and the other a with a mental health background, leading the psychoeducation groups. Study participants will be evaluated with several psychospcial/psychiatric measures including coping, functioning, social support, and quality of life as they contemplate or receive standard medical care for HCV. (Thisresearch project will not interfere with usual HCV treatment regimens. The problem-solving oriented psychoeducation program is not a replacement for psychiatric care, and psychiatric referrals will be facilitated when appropriate.) Effectiveness of the intervention will be measured through multiple outcome measures, including medical markers such as viral load. This innovative intervention is inexpensive, requires no special equipment or difficult procedures, and can be exported to diverse HCV treatment settings and implemented without extensive training. HCV-PERFhas the potential for major positiveimpact on the HCV population to save lives, reduce costs, and improve medical outcomes.