Abstract
A two- to three-fold increase in mortality from hepatitis C is predicted in the next 10-20 years as the largest cohort of patients age. More qualified providers are needed to care for this population. The objective of this study was to assess the impact of a hepatology nurse practitioner as compared to care by a physician on the quality of life and treatment outcomes of patients with chronic hepatitis C. Seventy-five patients with chronic hepatitis C were assigned to either a nurse practitioner or physician and asked to complete a SF-36 Health Survey quarterly to measure their perceived quality of life.
Two-sided t-tests comparing the quality of life scores in the physician and nurse practitioner groups at weeks 1, 12, and 24 were calculated using SPSS version 12.0 (Chicago, IL). Although marginal differences between physicians and nurse practitioners were noted for physical function at week 1, bodily pain at week 12, and role physical at week 24 by the patients, no statistically significant differences were observed overall in the quality of life scores reported by the patients according to healthcare provider. The treatment outcome data for the nurse practitioner groups showed 12/25 (48%) of patients with genotype 1 achieved a sustained virologic response as did 13/22 (59%) of patients with genotype 2 or 3. In the physician groups, 11/27 (41%) of patients with genotype 1 achieved a sustained virologic response as did 14/23 (61%) of patients with genotype 2 or 3. These results suggest nurse practitioners can provide effective care to the chronic hepatitis C population.