Models Of Care For The Management Of Hepatitis C Among People Who Inject Drugs In Southern Switzerland: Role Of Nurses

Author: Finessi V, Nottaris A, Rudel G, Borojevic M, Messina P, Moriggia A

Theme: Clinical Research Year: 2017

Hepatitis C Virus (HCV) treatment can be successfully administered in People Who Inject Drugs (PWID) if delivered in adequate settings with multidisciplinary models of care.
We described the role of nurses in three different settings of HCV treatment for PWID in Southern Switzerland: 1) tertiary center for liver disease with specifically trained nurses; 2) integrated treatment “all under one roof” in addiction center; 3) directly observed therapy. We analyzed and compared HCV therapy results and characteristics of the patients in the three groups.
Among 66 treated patients, mean age was 48 years, 24% (16) were women and 27% (18) failed a previous HCV therapy. Most of the patients (41) were treated in a tertiary clinic for liver disease with the support of nurses with expertise in PWID management (Model 1). One patient was lost of follow up, 3 had a virological failure and 37 (93% of those who completed treatment) met a sustained virological response 12 weeks after end of treatment (SVR12). Twenty-one patients were treated in an addiction center through an integrated care model involving HCV specialist doctor, psychiatrist, nurses and psychosocial support “all under one roof” (Model 2). Of those, 2 died during treatment for reasons unrelated to HCV therapy, 1 stopped treatment for nonadherence, 1 had a virological failure and 17 (94% of those who completed treatment) met SVR12. Only 4 patients were treated as a directly observed therapy during their stay in a stationary rehabilitation center (Model 3). All of them completed the treatment successfully and reached the SVR12 (100%).
Our observation suggests a similar efficacy among the three models of treatment of HCV among PWID. It is important to offer different models of management of HCV, to be able to remove the barriers to access to care in this population.

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