Theme: Models of Care Year: 2022
Background:
People with hepatitis C (HCV) may be admitted to hospital for other indications, giving an
opportunity to engage or re-engage them in care.
Description of model of care/intervention:
People with HCV either untreated or treated with unknown outcome were identified from a HCV
database and virus lab data. Using a patient unique identifier, linkage was performed with a patient
management system (trakcare) to identify such patients currently in hospital. HCV nurse specialists
were encouraged to access this information via a web based dashboard on a daily basis. When a
patient was identified they would contact the admitting team to request any required pre-treatment
bloods or check SVR bloods as appropriate. When possible, in-reach pre-treatment assessment was
performed, or alternatively outpatient appointments arranged. The dashboard was not interrogated
at weekends, or if nursing time/pressures did not allow.
Effectiveness:
Of 4081 patients of interest, there were 382 admissions relating to 230 (5.6%) patients in a four
month period September-December 2021. Admissions were most commonly under Medicine (221
(57.8%), followed by day case admissions (62, 16.2%) and psychiatry (34, 8.9%). Excluding day case
admissions, 180 patients were identified. Of these 64 (31.6%) had updated virology and 35 (19.4%)
have started on treatment (33) or have a planned start date (2), as of 1st March 2022 (follow up 3-6
months).
Conclusion and next steps:
The use of a web based dashboard was effective in re-engaging patients with HCV in care during or
following a hospitalisation. Approximately 1:3 patients had updated virology, and 1:5 were
commenced on treatment. The dashboard will continue to be used. Pro-active alerts (via email to
the appropriate hospital team), or dedicated nursing time may further improve utility.
Disclosure of Interest Statement:
Stephen Barclay has received speakers fees and advisory board fees from Gilead, Abbvie and
Intercept.