Outcomes of a tertiary-based innovative approach to engage primary care providers in provision of hepatitis C treatment in community settings

• Published in: BMC public health Vol. 19; no. 1; p. 1335
• Main Authors: Pourmarzi, Davoud, Thompson, Hayley, Thomas, James A, Hall, Lisa, Smirnov, Andrew, FitzGerald, Gerard, Rahman, Tony
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 22-10-2019; BioMed Central; BMC
• Subjects: Adult; Aged; Aged, 80 and over; Analysis; Antiviral agents; Antiviral Agents - therapeutic use; Australia; Care and treatment; Community-based; DAA; Diffusion of Innovation; Female; Health care industry; Hepatitis C; Hepatitis C - drug therapy; Hepatitis C virus; Humans; Male; Management; Middle Aged; Outcome and process assessment (Medical care); Physicians, Primary Care - psychology; Primary care; Primary health care; Risk factors; Tertiary Healthcare - methods; Treatment Outcome; Young Adult; Australia; Hepatitis C; DAA; Primary care; Community-based
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-019-7604-5

Australia is committed to eliminating the hepatitis C virus (HCV) by 2030. Despite regulations in Australia that enable the prescription of subsidised direct acting antiviral (DAA) by primary health care providers, the number of providers who treat patients for HCV remains low and this limits the prospect of HCV elimination. The Prince Charles Hospital, Brisbane, Australia, implemented an innovative program called Cure-It aimed at engaging primary care providers in community-based HCV treatment. This paper aims to describe initial experiences and short-term patient outcomes of this program.
A formative evaluation was conducted using program data for the period March 2016 to April 2018. Descriptive statistics were used to report the number of engaged primary care providers, patients' baseline characteristics, treatment plans, and treatment outcomes.
Thirty primary care providers from different settings were engaged in HCV treatment. Among 331 patients eligible for community-based treatment, 315 (95.2%) commenced treatment, the completion rate was 92.4 and 66.5% achieved sustained virological response at 12 weeks (SVR12). The SVR12 had not been documented for 26.8% of patients. Among patients whose SVR12 was documented, 98.2% achieved SVR12. Only 1.3% of patients experienced treatment failure.
A flexible tertiary-led model can improve primary care providers and patients' engagement with provision of HCV treatment. Tertiary centres need to play their role to improve the accessibility of HCV treatment through providing training and on-going support for primary care providers while enabling those providers to become more confident in providing treatment independently.