Theme: Models of Care Year: 2024
Background: People living with hepatitis C from marginalized groups encounter many barriers to accessing hepatitis C treatment in traditional settings, resulting in low treatment uptake. A flexible, client-centred, same-day test-and-treat model implemented in the Mid North Coast Local Health District, a rural and regional area in New South Wales, Australia, aims to remove access barriers and facilitate movement through the cascade of care from assessment to treatment in one visit, increasing treatment rates in at-risk people who would normally not access mainstream healthcare services.
Description of model of care/intervention/program: The same-day-test-and-treat model forms part of an assertive outreach model of care. Nurses perform assessments in a variety of outreach locations such as such as homelessness services, community corrections and Needle and Syringe Program services. Point-of-care testing is used to assess for HCV and exclude hepatitis B and HIV. Mobile transient elastography is used to assess fibrosis status. People who test HCV positive are prescribed treatment by the Nurse Practitioner or General Practitioner who is part of the outreach team. An electronic prescription is sent to a private pharmacy for Direct-Acting-Antiviral (DAA) medications. A seven-day DAA starter-pack, supplied by the pharmaceutical companies, is provided on the spot to the client. The outreach nurse facilitates access to the remaining DAA treatment course and provides on-treatment support and follow up testing to assess treatment outcomes.
Effectiveness: The model allows the client to receive their medication within two hours of initial assessment. At the time of writing the model is being trialed. Outcome data will be reported on at the conference.
Conclusion and next steps: The hepatitis C same-day-test-and-treat model of care will remove barriers faced by people from at-risk populations to access hepatitis C treatment and facilitate progress through the cascade of care from assessment to treatment on the same day.
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