Background:
Early linkage to care is a critical step in the management of hepatitis C virus (HCV) infection, particularly in patients diagnosed through emergency department (ED) screening programmes. However, several barriers may interfere with this process. The aim was to analyse documented barriers to linkage to care in patients diagnosed with HCV through ED screening.
Methodology:
A retrospective analysis of patients diagnosed with HCV through opportunistic ED screening between August 2021 and September 2024 was conducted. Medical records were reviewed to identify reasons that prevented initial linkage to care.
Results:
Of the 83 diagnosed patients, 78% were contacted for linkage to care. For the remaining 22%, the main barriers identified were: death (Exitus), which accounted for 55.6% of cases, including patients who died during admission, with terminal tumour disease or with a poor prognosis. Location problems affected 33.3% of patients who could not be contacted due to missing details, living outside the community or not responding to repeated communication attempts. Finally, critical medical conditions or clinical decisions accounted for 11.1% of cases, including patients with severe pathologies such as poor prognosis tumours or critical co-infections, where it was decided not to prioritise treatment or to refer to other specialists.
Conclusion:
The main barriers to linkage to care in patients diagnosed with HCV by ED screening include death, location problems and critical clinical conditions. These findings highlight the need to develop strategies that address these barriers to maximise the impact of screening on HCV elimination and ensure timely access to care.
Disclaimer: Gilead Sciences’ FOCUS Program funding supports screening & linkage to a first appointment after diagnosis regardless of how organizations handle subsequent patient care and treatment. |