Abordaje multidisciplinar como modelo de detección y seguimiento de la morbilidad psiquiátrica en pacientes en tratamiento con interferón y ribavirina

Purpose: We aimed to describe the incidence of psychiatric disorders in a cohort of HCV infected patients treated with interferon and ribavirin, and their impact on treatment adherence and viral response rate (SVR). Materials and methods: Retrospective analysis of a cohort of HCV patients visited at an outpatient pharmacy service (OPS). We included all adult patients monoinfected with HCV who had initiated treatment in 2010. Monitoring of psychiatric disorders was assessed at weeks 0, 4, 12, 24, 48, and 72 through the self-administered questionnaires Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (Goldberg). Adherence to treatment was assessed by counting of drug dispensations and patient reporting and drug exposure with the 80/80/80 rule. Virologic response was determined by the physician according to standard definitions. Results: Among 76 included patients, 19 (25%) had a preexisting psychiatric disorder. The incidence of confirmed psychiatric disorders was 33% (n=25), with a peak of abnormal results in the tests by week 12. Overall, 43% of patients achieved an SVR. There were not significant differences between strict adherence and SVR in patients with or without medically confirmed disorders (96.0% vs 96,8%; p = NS) and SVR (39% vs 52%; p = NS], respectively. Conclusions: Psychiatric side effects had no effect on adherence to treatment nor on attainment of SVR. Multidisciplinary monitoring provided during the treatment of hepatitis C can contribute to early detection and management of psychiatric disorders and to improve integrated patient care.