c ˘ˇ ˆ˙˝˛˚ - marianna uigakukai.marianna-u.ac.jp/idaishi/www/325/07-32-5motodate...

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臨腷腹腩腼腳膄膋臹膒膿臆 Vol. 32, pp. 461469, 2004 腞腖腚腇腟腁腃 C 腒腝腗腐腎腏腕腄腘腂腆 腈腍腊腀腋腉腌腍腠腜腅腛腔腟腄腑腂腆腓腙 腞腗 腓腖 腙腡 1 1 腏腐 腑腄 1 腠腍 腈腣 1 腎腤 腟腏 1 腠腕 腟腘腊 腚腢腍 2 腏腐 腝腔 腚腢 2 腗腅 腛腝 2 : 16 10 19 腫腼腲腀腶腭腻腼膄腮腍腒腋腦腐 C 臣膙膆膖臋腙臙臦膔臀臇腨膪腷腅腍腒腌腐2001 6 膩腆腣腍腒腌腐2001 12 膩腙腫腼腲腀腶腭 腻腼腹腴腵腹腼腧腽膄腮腍腒臈腘膎52 腨臷臗腕腌腓膪腨膶腑腐腚臮 腟腣腦臵腂臑腘腝腢86ῐ῏86ῐ῏臱臩腦80ῐ῏腔腁腑腐腠腉腚腘臬腙臓臅膭腔腙膸腢腤膷腉腍腒腘腢腤腠腉腨腢腤臥 膑腘腾腍腥腊腕腇膊腔腁腥腕膵腄腣腦腐臙臦膔臀臇腇致腗腧腦腓腂腥膖臋腚臮臶腙 3 1 腨自腟腓腂腐腘腢腥臉膅臺腟腣腦腎腍腒腈腟膼腆腗 腯腩腨膶腃腊腕腇腨膀臮腘膧至腍腥臘腔腻腽腕臃腧腦腐ῐῌ῏ C 臣膙膆腫腼腲腀腶腭腻腼腹腴腵腹腼C 膥膙膆腬腪腺腱腮腸腹腩腚膮膽臮膹腘 200 腂腥腕臡腋腦腓腅腤 1臻腌腓腅腉腕膨膰 30 腙膦膌腔膙膴腡膙膝腘臞膶腍腥 2腐腇腑腓腬腪腺腱腨臒腌膙膴腡膙膝腛腙臞 膶腨腕腟腥腊腕腇臏腔腁腥腫腼腲腀腶腭腻腼 IFN腚腊腙腷腅膁腽腋腦腬腪腺腱臒腙腞腗 腣腎膙腋腣腘腚臦腲腼膰腨膎臭腍腥腊腕腇臖 腋腦腓腂腥 35腋腣腘2001 12 膩腢腤膇腕腗腑腐腹腴腵腹腼腕腙腧腽膄腮膁膈腧腽膄腮膺腝腔臉腕腋腦腓腈腐膃臂膥 1b 腆腒 膷腬腪腺腱腙臕腘臷腌腓腠膷腂臯膲腨臊腍腊 腕腇臖腋腦腓腂腥 67腌腆腌腏腙腜腴腇臐膮腍腥腐腟 89腨膕腍腥腝腔腙膖臋 腙膤腚臹腈腂腫腼腲腀腶腭腻腼臉腚臵腉腙腃腐 膯腣腦腐臜臈膚腨臥膑腘腾腍腥 腊腕腚腌腂腕膵腄腣腦腥腊腙腐腟腂腓臕臚腙臐膮腠腉腜腥腊腕腇腻腽腔腁腥腕膵 腄腣腦腥腊腦腝腔臧臛臕臚腘膛腌腓腚 Self-rating Depression Scale SDS, Hospital Anxiety and De- pression Scale HAD 腗腖腙腂腐 膸腇膹膐腆腣腋腦腓腂腥 1011腝腐膖臋腙 Quality of Life 腘膛腌腓腚 SF36 1112Hepa- titis Quality of Life Questionnaire HQLQ腐膪1314腇膏膐腆腣膸腋腦腓腂腥腌腆腌腗腇 腣臝臶臕臚腨腘臲腄腐腨腫腼腲腀腶腭 腻腼臉臼腘腍腒腌腐膸腚膍腐膯腤膫 腣腦腗腂臨腷腹腩腼腳膄膋臹膒臔膉膟膙臰膋膐1 臨腷腹腩腼腳膄膋臹膒 膘膱2 膋膒臔膉膟膙臰461 45

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Page 1: C ˘ˇ ˆ˙˝˛˚ - Marianna Uigakukai.marianna-u.ac.jp/idaishi/www/325/07-32-5Motodate Noriko.pdf · Vol. 32, pp. 461 469, 2004 C ˘ˇ ˆ˙˝˛˚ ˜ ! 1 1 1 1 ˘ ˘ ˇ ˇ ˆ 1 ˆ

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Page 2: C ˘ˇ ˆ˙˝˛˚ - Marianna Uigakukai.marianna-u.ac.jp/idaishi/www/325/07-32-5Motodate Noriko.pdf · Vol. 32, pp. 461 469, 2004 C ˘ˇ ˆ˙˝˛˚ ˜ ! 1 1 1 1 ˘ ˘ ˇ ˇ ˆ 1 ˆ

�� 2001� 6���� IFN ��������� ���� ������������������ � ������ !��"#$��%&�'��(���)����*+�,-.)� /�� � 12��������0�� 1�(���2�� ����*+�%&�.)� 345�67�89� ��� !:�!;<=>�,#?@9�(���AB�C��)�9� D�EF�55��GH��

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!� �"� �{� |#� }$�r� %&~�� ������#���#����x�����'�)�#�� �'�W)-�� ���;����=(R���)#*+�,-)� EF��,�W)-�� �-���� ��.)�

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� IFN ����������,-�./�'()IFN �����e��(��1�������*+�,-)� 30�i@��u�_)�����/0�/���67��� �10�e�0�50��� 38�Ci@��!�33��� 9W�� D�V� }$�r��"� ��_� r�2�� �3��D�V�T�u�_)�� IFN-����������������,-�./�'()IFN-����������e��(��2���

,-)����yzEF� Table 1 ��H� � "¡����T 50�i@�� ��u�_)�@¢�����|#�45�6����_9 80�i@���_� �7�£~� ¤¥¦£~� §¨¦£~� ©ª£~'«¬#£~T­8�vw�)������ �®39¯°±�²��G��­� 9W-)15�� f)� ³��:;s 65.6�9.3 kg� :;´<L 60.8�9.7 kg9W-)��(�9 �D�V� �JU�W-)���'D�

Figure 1. An interview form for patients receiving IFN

monotherapy.

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46

Page 3: C ˘ˇ ˆ˙˝˛˚ - Marianna Uigakukai.marianna-u.ac.jp/idaishi/www/325/07-32-5Motodate Noriko.pdf · Vol. 32, pp. 461 469, 2004 C ˘ˇ ˆ˙˝˛˚ ˜ ! 1 1 1 1 ˘ ˘ ˇ ˇ ˆ 1 ˆ

����� �Table 2� ���� ��� ��������������������� 50�� 34��23�� 23������ �� �������������� ���������������!"#$���%&��' (�� �Table 3� )*+� ,�"#$(-.&/�0'1���� �234-.�56�+78�9:���;<=> � � � ?@4 8ABC) 4A�)�DE'1;������� �FG�H�IJ���14 �Table 4����0:�

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Figure 2. An interview form for patients receiving IFN-ribavirin com-

bination therapy

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47

Page 4: C ˘ˇ ˆ˙˝˛˚ - Marianna Uigakukai.marianna-u.ac.jp/idaishi/www/325/07-32-5Motodate Noriko.pdf · Vol. 32, pp. 461 469, 2004 C ˘ˇ ˆ˙˝˛˚ ˜ ! 1 1 1 1 ˘ ˘ ˇ ˇ ˆ 1 ˆ

������� 20���� ���� ��������������� ��������28� 13��!�"����#$%&� '�() 12� �*+,�&��3� �-����*��.�/0����1�$%&15����� � 7 ��0�23�456� 35 � 22�������&� 078�9: ;<=�/16 ��>?@ABC"�D��E�F@GHIJ�D���*#K�� 20�078*LM�&��4� N�6��0���%/O�� PQ�RS�4T�*

U RSV��� ��WX���=%/4Y�$�8� � ��*ZK�[\U/� ]=�^��/_`�/V�aba��6&� �&� �� �9c=�/� defg�h6�iU ]=� �j��U ]=��k�&� N��l�����9�/4m�n0o��pq $Q�/9r�&��5� s� ts� t�9�/4� u�v!$s"���&swx�#%&�

�6� #$yz#aoyz*��&;e@4� ��{������� 3�*|}~��=$�� %"���*#K�&� ����&��'���]=�b�� ��������: ]=*v!�%&��7� IC�GC�35 � 1 ����&� ���(��'������������&� %"����=�U�����=������()� ���������&� IC�GC�4��Z)n����/�&��8� '��� 3�����b�� ��*�� +�&8�

� .��U&��V�&� �,=�a�&�����4� ���V_��+�����/���*�� �� ��V������-K�&�$�=+�2�/��a� ]����4� .��/*Vv!$]=� �0�$�ba�(�� ]�� 41+=1/*�¡2���*�=�&� �&� ����f¢£e¤�36�: ]=¥B¦§;e¨©C�nª�«4: ]=�U*+,�&�

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IFN ���4¬������5a]=*­��/O�� ��* IFN ����q 0Qa0�®6 ¯�6a°±=$ 8�9�� IFN ���#K$0%&RS� Cj²³���0�478 5�7��´S�µ: � �&� ²³��5K$� C j9X²¶

Table 2. Frequency of Side E#ects in Patients Receiving

IFN-ribavirin Combination Therapy �2�Table 1. Frequency of Side E#ects in Patients Receiving

IFN-Ribavirin Combination Therapy �1�

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48

Page 5: C ˘ˇ ˆ˙˝˛˚ - Marianna Uigakukai.marianna-u.ac.jp/idaishi/www/325/07-32-5Motodate Noriko.pdf · Vol. 32, pp. 461 469, 2004 C ˘ˇ ˆ˙˝˛˚ ˜ ! 1 1 1 1 ˘ ˘ ˇ ˇ ˆ 1 ˆ

���������16�� � � IFN ����������� �������������������� �������� !"#�����$%&'�� ()� ����)*���+,&-�����.�� /������0"����� IFN12���345�67� �8�9�:;�<=>�?�.��@>���� @������:����ABCD�EF�G�HI�����J@>�� KL���MNOPQRSN���TUABCD�EF�G�HI��V@>���11�14��� WX����V�� Y��Z[5\)]^_*�>��� ��:�ABCD�EF�G� )>������`a� @������b�����c��V�'^17�� U5)de���Z[�f����gh�>��ijklNmnopqrstuv�wxXo&

�� IFN ��yz�{��� (#L�&n|�}

������ ~*)���<=>� MNQ�P����N�N��\�>)�zs���� IFN ��yz�� 2���zs��:�� ��MjkP��|�}������R��� ����d���l� �8|�}����y�<�=>�s����L��0���� � 3����� 2�4�������<=>�� 2�������<=>�������� ��|�������� �n|�������� �� 6¡&'�� � ����¢ABCD�EF�G�HI�£��¤¥7)*��� n|�¦h� ��|��§�p-��5�5���L����� ��¢Z¨�©=��ª«¬­ �5(U)*� ��ª®��h���¯°¢�±�� n��²���³h�7�´µ� ��ª®�U(7�¶&-��´µ�'��gh�>�� U5)�±�·¸ �¹�5)��º����»��¼&'��

Table 3. Frequency of Serial Change of Side E#ects in Patients Receiv-

ing IFN-Ribavirin Combination Therapy

Table 4. Frequency of Patients with Damaged Daily Life

MNOPQRSN�����» 465

49

Page 6: C ˘ˇ ˆ˙˝˛˚ - Marianna Uigakukai.marianna-u.ac.jp/idaishi/www/325/07-32-5Motodate Noriko.pdf · Vol. 32, pp. 461 469, 2004 C ˘ˇ ˆ˙˝˛˚ ˜ ! 1 1 1 1 ˘ ˘ ˇ ˇ ˆ 1 ˆ

��������������� IFN �������� ������������� �� ����������������� ������ �����! �"#� ���$%�&�����������&��� '�(�) 11(��*�+� ��,�- .��'�)/012����3���������� 4������� 56���2���78���9�:#� �����; < =�����>?1��@AB@C��!�� .#2�D �E�F������ IFN ��� "G#2H#$�%$)I�4��&JK12��8�9�� 4������1�'�1�LE�)� '�()�M*N#2+O#� ,��������#�� 0�� �����2�+4����2)�������,�- PQ����R-���4��?��2��� 4���� �,�- .��(��.�O��� S�TU� 3*� 1��,�- PQ���#2��4��/0#��������#�4��V��#2� W�X�6��+����12���� =�2��YZ�[=4���3\�]�^�� P[��4��_4 ���4���`�1�� -�X56ab�7�� 608�c9�� �d:��+�6eR�>�5� ���+���� f<� �34)g+����� ;�h���7�2)i<���=j#2)����� ���8���� �7��� k* ��>�� �?K�]���� W���i<l@b�A0��YZ�BC#�� fD]���m Fn���?�>��>+4��op0�������4��_4����� 0�� qCrsCt�7��E9�� ��� =�2�FG�uv����� wH��+#2#0��S�I��x6:#�� 9 .��3\�Jn�yK�Lz ��?�uM�4� )��?�{� W� � �:# +�3\���� 4� �#2�N|O ��>+�} W� ~&P���4���������4��_4 ����@AB@C��!�������� ��� 5����^��6� �K ���Q��E��)� 181- 14-�7.7������^K12��16�� ���R#� 35-��� 1-�ST-):2���� ����R�*U-���R������

���� k*Fn���2����4��������2�+�V�[���2)��4�� K� ����ST���U����4��_4���4����#2���@AB@C��!�� .#2�� WCX� 8

����Y��Z[K11X� Y���X#2)�\]�^�#��4��/0#2��18�� ������a- .#2�_`��r���\��������4�)���>?1� Y���X .#2)W��Y����#������R��aM)����K�R� IFN ����p��fDN|�D�#2���)����� IFN ��� ��b� qC���C�ab�c�#�d������:������ fDN|ph����+� �|�����/���R�aM���� S4�@e�����:�f|Fgh����#2i�� 2003j 7�����#2�� �Figure 3��  D� �����w¡¢=�£���¤��¥k#� �����"�¦C�§���w�&��¨;� �� ©6lª��+4���m�#2��� 0�� K�R��n«��O������¬���?�������� ����#$ .#2�X�=����� �p��­�$ ����!® �¬#� �R�O��aM����2003j 12��� PEG-IFN a-2a ���19��o

¯����6� ° 1��p±���4�� ����%$�²�4����³q�{�´ª²�K1�� 0��p���WCK12��µ¶ IFN �@AB@C�!���K� S�VU�;rK1�

Figure 3. A communication form connecting hospital

ward and outpatient clinic.

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Page 7: C ˘ˇ ˆ˙˝˛˚ - Marianna Uigakukai.marianna-u.ac.jp/idaishi/www/325/07-32-5Motodate Noriko.pdf · Vol. 32, pp. 461 469, 2004 C ˘ˇ ˆ˙˝˛˚ ˜ ! 1 1 1 1 ˘ ˘ ˇ ˇ ˆ 1 ˆ

C������ IFN ���� ��� ���� �� ������������ �!"#$�%�&� '()*+)�,- ���./�0�� 1234 �5678��&9:#0;�1<� 12�56#=�&>? �@A�$� BCDE�FGHIJ� ���KL&0�;��*M��

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1� NOPQ� RSTQ� UVW� XYTQ� Z[\]� ��^_`abc�de� fg+ 2004;30: 1579�1584

2� Matsumura H, Moriyama M, Goto I, TanakaN, Okubo H, Arakawa Y. Natural course of

progression of liver fibrosis in Japanese pa-

tients with chronic liver disease type C-a study

of 527 patients at one establishment. J Viral

Hepat 2000; 7: 268�275.3� Yoshida H, Shiratori Y, Moriyama M,

Arakawa Y, Ide T, Sata M, Inoue O, Yano M,

Tanaka M, Fujiyama S, Nishiguchi S, Kuroki

T, Imazeki F, Yokosuka O, Kinoyama S, Ya-

mada G, Omata M, for the IHIT Study Group.

Interferon therapy reduces the risk for hepato-

cellular carcinoma: national surveillance pro-

gram of cirrhotic and noncirrhotic patients

with chronic hepatitis C in Japan. Ann Intern

Med 131; 1999; 131: 174�1814� Imai Y, Kawata S, Tamura S, Yabuuchi I,Noda S, Inada M, Maeda M, MD, Shirai Y,

Fukuzaki T, Kaji I, Ishikawa H, Matsuda Y,

Nishikawa M, Seki K, Matsuzawa Y. Relation

of Interferon Therapy and Hepatocellular Car-

cinoma in Patients with Chronic Hepatitis C.

Ann Intern Med 1998; 129: 94�995� Yoshida H, Arakawa Y, Sata M, Nishiguchi S,Yano M, Fujiyama S, Yamada G, Shiratori Y,

Omata M. Interferon therapy prolonged life

expectancy among chronic hepatitis C patients.

Gastroenterology 2002; 123: 483�4916� McHutchison JG, Gordon SC, Schi# ER,Shi#manML, LeeWM, Rustgi VK, Goodman

ZD, Ling MH, Cort S, Albrecht JK. Interferon

alfa-2b alone or in combination with ribavirin

as initial treatment for chronic hepatitis C.

Hepatitis Interventional Therapy Group. N

Engl J Med 1998; 339: 1485�927� Davis GL, Esteban-Mur R, Rustgi V, Hoefs J,Gordon SC, Trepo C, Shi#man ML, Zeuzem

S, Craxi A, Ling MH, Albrecht J. Interferon

alfa-2b alone or in combination with ribavirin

for the treatment of relapse of chronic hepatitis

C. International Hepatitis Interventional Ther-

apy Group. N Engl J Med 1998; 339: 1493�988� hijk: _lmnopql �IFN�r3:*8�st� �uv 1990; 21: 899�904

9� hijk: C������: '(wx 2001; 47:27�32

10� yYz{� |�}~�� ?z��� �� _lmnopql��S&�A���C��&���������57�9:� ��*a��n�l�� �C+e 1998; 40: 717�721

11� Hunt CM, Dominitz JA, Bute BP, Waters B,Blasi U, Williams DM. E#ect of Interferon-a

Treatment of Chronic Hepatitis C on Health-

Related Quality of Life. Dig Dis Sci 1997; 42:

2482�248612� Ahern M, Imperial J, Lam S. Impact of adesignated hepatology nurse on the clinical

course and quality of life of patients treated

with rebetron therapy for chronic hepatitis C.

Gastroenterol Nurs. 2004; 27: 149�5513� Ware JE, Bayliss MS, Mannocchia M, Davis

GL, and the international hepatitis interven-

tional therapy group.

14� Health-Related Quality of Life in Chronic

Hepatitis C: Impact of Disease and Treatment

Response. Hepatology 1999; 30: 550�555.15� Perrillo R, Rothstein KD, Rubin R, Alam I,Imperial J, Harb G, Hu S, Klaskala W. Com-

parison of quality of life, work productivity

and medical resource utilization of peginter-

feron alpha 2a vs the combination of interferon

alpha 2b plus ribavirin as initial treatment in

patients with chronic hepatitis C. J Viral Hepat

2004; 11: 157�16516� hijk� ���� XR��� �[��� ��� � ¡¢£¤� ¥¦§� |R¨§� ¡©ª

_lmnopql��*567 467

51

Page 8: C ˘ˇ ˆ˙˝˛˚ - Marianna Uigakukai.marianna-u.ac.jp/idaishi/www/325/07-32-5Motodate Noriko.pdf · Vol. 32, pp. 461 469, 2004 C ˘ˇ ˆ˙˝˛˚ ˜ ! 1 1 1 1 ˘ ˘ ˇ ˇ ˆ 1 ˆ

�� ��� Genotype 1b������� C ���������������� a-2b �SCH 18908 �������� !"#��������� a-2b $%"#��&'�()*+,-&'./!01!.�!��+2�3456 2002; 18: 565�591

17� Matsumura H, Moriyama M, Goto I, TanakaN, Okubo H, Arakawa Y. Natural course of

progression of liver fibrosis in Japanese pa-

tients with chronic liver disease type C�a studyof 527 patients at one establishment. J Viral

Hepat 2000; 7: 268�75.18� Bernstein D, Kleinman L, Barker CM, Revicki

DA, Green J. Relationship of Health-Related

Quality of Life to Treatment Adherence and

Sustained Response in Chronic Hepatitis C Pa-

tients. Hepatology 2002; 35: 704�708.19� Mchutchison JG, Manns M, Patel K, PoynardT, Lindsay KL, Trepo C, Dienstag J, Lee WM,

Mak C, Garaud JJ, Albrecht JK, for the inter-

national hepatitis interventional therapy

group. Adherence to combination therapy en-

hances sustained response in genotype-1 in-

fected patients with chronic hepatitis C. Gas-

troenterology 2002; 123: 1061�106920� Zeuzem S, Feinman SV, Rasenack J, Heath-cote EJ, Lai MY, Gane E, O[Grady J, Reichen

J, Diago M, Lin A, Ho#man J, Brunda MJ.

Peginterferon alfa-2a in patients with chronic

hepatitis C. N Engl J Med 2000; 343: 1666�1672

789: ;<=>�? @468

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Abstract

A Study on the Side E#ects of Interferon Treatment Using a

Questionnaire for Patients with Chronic Hepatitis C

Noriko Motodate1, Mariko Akutsu1, Seiko Suzuki1, Kimie Yoshikawa1,

Yasuko Jinta1, Hiroshi Yotsuyanagi2, Michihiro Suzuki2,and Fumio Itoh2

An interview form was introduced for study of side e#ects, daily life� and work of patients withchronic hepatitis C who received interferon �IFN� treatment. The first interview form, introduced in June2001, was revised in December 2001. After that, side e#ects, daily life and work of the patients treated by

IFN-ribavirin combination therapy were analyzed. All the patients had some side e#ects. Common side

e#ects were skin itching followed by alopecia and edema. The frequency of each side e#ect is higher than that

on phase-III clinical trial, showing that the interview form can pick up side e#ects more accurately. Daily life

and work were damaged in one-third of the patients. However, no patient stopped treatment due to side

e#ects. Our experience shows the usefulness of interview form for intensive care and safe treatment.

Key words

Chronic hepatitis C, Interferon, Ribavirin, Questionnaire

1 Department of Nursing

2 Department of Internal Medicine, Division of Gastroenterogy and Hepatology, St. Marianna University.

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