Theme: Models of Care Year: 2024
Background: Established in 2020 to increase access to treatment in rural and regional New South Wales (NSW), Australia, and other settings where treatment access may be limited, the NSW Hepatitis C Remote Prescribing Program facilitates linkages between nurses who perform the patient assessment and hepatitis C treatment prescribers.
Description of model of care: The model of care is nurse-led and patient centred. Nurses perform hepatitis C assessments in a variety of settings. They complete the Remote Consultation Request for Initiation of Treatment form, (developed to facilitate the efficient exchange of comprehensive clinical information) and email it to a prescriber who reviews the information and sends a prescription for hepatitis C Direct-acting-antiviral (DAA) therapy to the pharmacy nominated by the patient. The referring nurse facilitates access to the medication and provides follow up support and testing.
A prescribing pathway summarises the roles and responsibilities of participants. A deidentified data collection form monitors program outcomes.
Effectiveness: There are currently 10 prescribers, comprising six medical practitioners and four nurse practitioners, and 22 nurse referrers in the program. Most referrals are from regional and remote locations.
In 2023, a total of 108 patients, including 25 who identified as Australian First Nations people, were referred by 16 nurse referrers and prescribed DAA therapy by two Nurse Practitioner remote prescribers. Patient referrals included seven from Aboriginal Medical Services, 20 from Alcohol and Other Drugs settings, 23 from General Practice, 17 from homelessness settings, three from Liver Clinics, five from Mental Health settings, five from Community Corrections, two from Needle and Syringe Programs and one from Pregnancy Care Services.
Conclusion and next steps:
The NSW Hepatitis C Remote Prescribing Program has demonstrated highly successful outcomes and has application across a wide range of settings where people living with hepatitis C may have limited access to treatment prescribers.