Theme: Models of Care Year: 2019
Increasing the number of trained hepatitis C treatment providers and reaching IV drug users
(IDU) are crucial to achieve Hepatitis C Virus (HCV) elimination.
Description of model of care/intervention:
The ECHO® model consists in linking through multipoint videoconferencing an interdisciplinary
expert team with community-based healthcare professionals. Providers learn best practice
through co-management of real-world patients with increasing self-efficacy and independence.
In 2017, we launched the first French speaking ECHO® hepatitis C program. Participants present
de-identified cases during bimonthly teleClinics. Discussion and guidance from the hub
(hepatologist, addiction specialist, infectious disease specialist, nurse, pharmacist) lead to
recommendations. A learning capsule with pre/post questionnaires concludes the session.
From april 2017 to april 2019, 83 professionals (38 nurses, 23 general practitioners, 4 pharmacists,
18 other) were enrolled in the program; 42 teleClinics were conducted and 58 cases discussed.
Of these, 49 had a history of lifetime drug use, 36 (62%) actively using drugs and 15 (26 %)
actively injecting. Direct-acting antivirals were recommended in 46 persons (29 actively using;
10 active IDU) and initiated in 31 persons (17 actively using drugs; 6 actively injecting). Naloxone
kits prescription and opioid agonist therapy were discussed 9 times. Recommendations were
regularly issued by the hub pharmacist. Thirty cases (52%) were presented by nurses.
Pre-post tests comparison demonstrated an increase in participants’ knowledge, mean 21 % (-
13.3% – 80%). Self-confidence evaluation and updated SVR will be presented at the meeting.
Conclusion and next steps:
This ECHO® program enabled professionals to increase their knowledge in treating hepatitis C and
provided opportunities to cure HCV infected IDU as well as discuss harm reduction strategies. Our
results underline the prominent role of nurses in managing hepatitis C. Our next goals are to
capturate the full impact of the program, evaluate its return on investment and ensure its
Disclosure of Interest Statement:
The ECHO CHUM Hepatitis C program is supported by Merck Canada, Gilead and AbbVie