Theme: Models of Care Year: 2021
Background: Populations in areas of high socio-economic deprivation are known to be disproportionately affected by Hepatitis C virus (HCV) infection. In order to achieve elimination of HCV, diverse models of care will be required to reach all patients. Traditionally, HCV treatment has been delivered by secondary care based specialists which can be a barrier to accessing treatment. We describe a model of care for patients to access treatment in a primary care setting situated in a socio-economically deprived community. Description of model of care/intervention: Patients were identified and assessed by a primary care physician (PCP) based in a health centre. Liver fibrosis was assessed using biochemical markers. Electronic referral was made which was reviewed in secondary care based multidisciplinary team by consultant hepatologist, specialist pharmacist and nurse. Treatment plan was documented and returned electronically to the PCP. Prescribing was undertaken by specialist pharmacist. Medicines were supplied by local community pharmacy providing additional support and monitoring of adherence. Patients remained under care of PCP for duration of treatment including measure of success by Sustained Viral Response (SVR) 12 weeks after cessation of treatment. Effectiveness: From December 2018 to January 2021, 26 patients were commenced on treatment. Timepoint for measurement of SVR 12 was reached in 25 patients and was achieved in 21 (84.0%), 4 (16.0%) have still to be obtained. No virologic failures found to date. Within the treatment naïve cohort (n=22), 12 (54.5%) had been previously referred into specialist services but had not accessed treatment. Conclusion and next steps: This model demonstrates successful collaboration of primary and secondary care whereby patients were able to access treatment and obtain cure in a convenient, accessible, community based setting. Models such as this are essential in the journey to elimination of Hepatitis C. Disclosure of Interest Statement: nil
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