Theme: Models of Care Year: 2021
Background: Both, the Swiss Hepatitis Strategy and the WHOaim to eliminate Hepatitis C (HCV) until 2030. The main gaps in the cascade of care are awareness, testing and linkage to care, mainly among people who use drugs (PWUD). General Practitioners (GP), prescribing 50% of all Opioid-AgonistTreatment in Switzerland, play a critical role to fill these gaps. They are currently not allowed to prescribe HCV direct acting antivirals (DAA), which has a negative impact on the motivation of GP to test and refer to treatment. HepCare, a nationwide project of Swiss Hepatitis, aims to improve the cascade of care of HCV by directly involving GPs and addiction psychiatrists in HCV therapy and enhances the motivation of GPs for case finding and linkage to care thus relevantly contributing to the elimination of HCV in Switzerland. Description of model of care/intervention: The HepCare Project allows GPs and addiction psychiatrists, and especially those taking care of patients in opioid-agonist therapy, to provide DAA treatment to their patients without referral. A network of specialist supports them with prescribing DAA through a file consultation. Thus, easy-to-treat patients remain with their primary care provider resulting in a lower threshold access to therapy. The project provides support and templates for the specialist as well as information and educational material for GPs and patients. Effectiveness: In a first pilot project, 10 patients were successfully treated proving that the procedure works well. All patients achieved SVR. Treatment reimbursement by the health insurance worked well for all patients. Conclusion and next steps: The HepCare project brings HCV therapy from tertiary to primary care with the potential to raise awareness and motivation for HCV care among GPs and to facilitate access to care for patients. A successful nationwide execution of the project would bring Switzerland an important step closer towards elimination of HCV Disclosure of Interest: The HepCare project is financed by grants from the Swiss Federal Office of Public Health, the Cantons of Aargau and Zurich, Abbvie, Gilead and Mediservice. PB received speaker fees, project and travel grants of Gilead, Abbvie and MSD. BM and CB have no personal conflict of interest to declare.
Download abstract Watch video