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Bailey Receives $431,750 Grant to Investigate Patient Self-Management and Gene-Guided Therapy for CHC

Associate Professor Chip Bailey received an award for his NIH R21 proposal entitled "Patient Self-management and Gene Guided Therapy for CHC" for a two-year period, awarded April 13, 2012, to March 31, 2014, at $431,750.

Treatment for chronic hepatitis C (CHC) will undergo a dramatic change this year when a new blood test for a genetic polymorphism near the interleukin 28B (IL28B) gene and two newly approved protease inhibitors are used to enhance patient response. The polymorphism is a strong predictor of treatment response for patients with genotype 1 infection, and the two protease inhibitors may cure CHC.

With genetic test results guiding the new therapy that is expected to worsen symptoms, provider interactions with patients have even greater potential to influence symptom trajectories and self-management (SM). Thus, this study will explore how providers (physicians, physician assistants, and nurses) interact with patients to share the new information and examine whether the way it is shared influences patents’ symptoms and SM over time. The adaptive leadership framework provides a useful way to describe the patient-provider relationship by distinguishing between technical work, adaptive challenges, and adaptive leadership.

This two-year exploratory mixed-methods longitudinal case study (n=18) will describe patients’ and providers’ explanations of how and why they engage in technical work, adaptive work, and adaptive leadership and how these strategies promote or pose barriers to patients’ SM in the context of the new genetic test results and treatments.