Insight 11: A nurse’s perspective, Denmark

(Treatment week 9 of 12)

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Q: What advice would you give to a patient who is starting treatment?


A: Firstly it depends on which kind of HCV the patient has. But generally - it's important that the person takes their medicine as directed, so as not to give resistance a chance. It's (normally between a 12 - 24 week treatment so most patients can manage this time span.


In Denmark

We see the patients every week, for the first 4 weeks so we can check the bloods and generally check for side-effects and the patient’s well-being. After this every month to cessation of treatment.


We speak to the patients about all possible side-effects. We also inform about what percent who will be cured and that in a small percent the treatment may not work. This is important that the patient knows this, as they have to be completely clear about what the plan will be if they relapse or are non-responders.


Treatment tips

•They may have headaches at the start of their treatment. Drinking water usually helps here.


•If they get dry itchy skin use baby oil while the skin is wet in the shower. (Skin still has to be wet otherwise it doesn't work - be careful not to slip!)


•No alcohol whilst in treatment- the liver needs to rest


•No 'herbal' therapies as we don't know all in drug interactions here.


•The patient must inform us about their medicine status so we can look interactions up.


•They are informed about diet (taken with food / or not and about fat content)


•We measure the effect of HCV in time and HCV RNA so it is paramount that the patient comes to their appointments


Treatment follow up

We inform the patient about the waiting follow up time after the treatment is finished. And after those 12 weeks follow up, it’s a great day for them and we make sure that they understand that they are cured. The plan after this ( if they had cirrhosis we'll see them every six months and ultra sound scan them every year - if fibrosis we can eventually discharge them from the out-patient clinic after 1 to years follow up - we fibro scan about every year here in both cirrhosis and fibrosis patients so they can see a bettering)



Q: How important do you feel peer to peer support is when patients are going through treatment?


A: For some patients this is important and we can link our patients to a mentor. Some patients do not feel they need peer to peer support and it is important that we listen to them.



Q: Hepatitis C treatments have advanced, but what challenges do patients still face in achieving their treatment goals?


A: It's always harrowing not knowing if the treatment will work for patients - and if it does, that they really believe the HCV is gone.


Many patients worry about side-effects. What will happen if the treatment doesn't work- will they go to the back of the queue? It is important that as health professionals we inform patients about future plans...



Q: How has your role as a nurse changed with new emerging treatments?


A: I feel that with the old treatments we 'carried' these terrible side-effects. Many ill patients when through up to a year’s treatment. It was a tough time for both patients and staff. (More for the patients of course)


Now the patients have more 'control ' most of them work full time and manage their everyday life well which is empowering for them. Especially them that have tried the old treatments.


Our role is among other things to help the patient manage their treatment and come out the other side with as little disruption to their life as possible - when at the same time helping they realize the importance of the routine that HCV treatment craves of the patients.



View a nurse’s perspective, UK


Q&A with Philippa Collins, Study Coordinator/Clinical Research Nurse, department of Infectious Diseases, Hvidovre Hospital, Denmark.



Philippa has many years research experience within HIV, HCV and other infectious diseases. Working primarily in a university hospital in Copenhagen performing Phase I-IV studies. She has a flair for study organization and team work prioritizing patient care within the multi-dimensional world that is clinical research.



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