The role of patient religiosity in the evaluation and treatment outcomes for chronic HCV infection.
To determine the influence of patient religiosity on the outcome of treatment of hepatitis C infection, a prospective, blinded, cohort study was performed on hepatitis C-infected patients categorized as 'higher religiosity' and 'lower religiosity' based on responses to a religiosity questionnaire. Comparisons were made between high and low religiosity patients on demographics, pre-treatment laboratory values, and response to treatment. Eighty-seven patients with complete questionnaires were placed in either higher (38) or lower (49) religiosity cohort. The patients (60% female) were ethnically diverse: African-American 39%; Hispanic 31%; white 29%. African-American race (P = 0.001) and female gender (P = 0.026) were associated with higher religiosity. The frequency of being offered treatment, accepting treatment, and completing treatment was similar in both religiosity cohorts (P = 0.234, 0.809, 0.367). Fifty-six patients completed the 24- or 48-week treatment with peginterferon and ribavirin. Depression was more frequent in the low religiosity group (38.2% vs. 4.6%, P = 0.005). Sustained viral response rate at 3-6-month post-therapy was similar in the higher (50%) and lower (57.6%) religiosity cohorts (P = 0.580; n = 55). Logistic regression modeling revealed that males having higher religiosity gave greater odds of SVR than those with lower religiosity (OR 21.3; 95% CI 1.1-403.9). The level of religiosity did not affect the decision to begin treatment for chronic HCV infection and was not associated with a better treatment outcome. A higher level of religiosity was associated with less depression among patients.
Department of Medicine, Division of Nephrology, Baylor College of Medicine, Houston, TX 77030, USA. rajeevr@bcm.edu
Rajeev
R
Raghavan
Laura
L
Ferlic-Stark
Cinda
C
Clarke
Manish
M
Rungta
Richard
R
Goodgame
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D055809:Illness Behavior; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D064887:Observational Studies as Topic; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D017060:Patient Satisfaction; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012068:Religion and Medicine; D012069:Religion and Psychology; D012189:Retrospective Studies; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use*; D012737:Sex Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D019562:Viral Load
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b
Soc Sci Med. 2006 Oct;63(8):2228-41
16797809
J Gerontol B Psychol Sci Soc Sci. 1997 Nov;52(6):S306-16
9403524
J Gen Intern Med. 2006 Dec;21 Suppl 5:S28-38
17083497
J Clin Psychol. 2005 Apr;61(4):461-80
15503316
Ann Intern Med. 2004 Mar 2;140(5):346-55
14996676
Arch Intern Med. 2005 Jan 10;165(1):88-91
15642880
J Gen Intern Med. 2006 Dec;21 Suppl 5:S5-13
17083501
N Engl J Med. 2002 Sep 26;347(13):975-82
12324553
South Med J. 2004 Dec;97(12):1201-9
15646758
JAMA. 2002 Jul 24-31;288(4):487-93
12132980
Dig Dis Sci. 2001 Oct;46(10):2060-5
11680576
South Med J. 2004 Dec;97(12):1223-30
15646761
J Clin Gastroenterol. 2007 Feb;41(2):185-93
17245218
Am Psychol. 2003 Jan;58(1):36-52
12674817
J Clin Oncol. 2003 Apr 1;21(7):1379-82
12663730
N Engl J Med. 2004 May 27;350(22):2265-71
15163776
Gut. 2006 Sep;55(9):1350-9
16905701
Lancet. 2001 Sep 22;358(9286):958-65
11583749
Int J Psychiatry Med. 1997;27(3):233-50
9565726
South Med J. 2004 Dec;97(12):1210-4
15646759
Ann Behav Med. 2002 Winter;24(1):14-21
12008790
Gynecol Oncol. 2006 Apr;101(1):102-7
16256181
South Med J. 2004 Dec;97(12):1194-200
15646757
N Engl J Med. 2006 Dec 7;355(23):2444-51
17151366
Int J Psychiatry Med. 1998;28(2):189-213
9724889
South Med J. 2004 Dec;97(12):1231-41
15646762
Gastroenterology. 2002 Oct;123(4):1061-9
12360468
JAMA. 2004 Jun 16;291(23):2880
15199041
J Palliat Med. 2006 Jun;9(3):646-57
16752970
Hepatology. 2004 Jun;39(6):1702-8
15185312