Abstract
Chronic hepatitis C is a major health burden world wide. Only 1% of people with hepatitis C in Australia have access to treatment. This paper addresses the issue of motivating people with hepatitis C to seek treatment and the strategy of introducing the nurse practitioner role to effect this change. Objective: To demonstrate that the introduction of a nurse practitioner service model is an effective and safe way of increasing access to treatment for people with chronic hepatitis C. Setting: A multidisciplinary liver service at Royal Perth Hospital, a tertiary referral centre in Perth, Western Australia. Subjects: People with chronic hepatitis C managed in a state wide chronic hepatitis C service. Primary Argument: To make any impact on controlling the hepatitis C epidemic in Australia, the number of people in treatment will have to triple annually. Improved access to treatment includes the removal of mandatory liver biopsy as a requirement to treatment and an increase in the accessibility and availability of effective medicines. Nurse practitioners can function independently within clinical protocols approved by the designated service and the Director General of Health. The scope of practice of nurse practitioners includes the legislated right to prescribe specific medications and initiate diagnostic investigations as specified in clinical protocols. The hepatology nurse practitioner works in collaboration with medical practitioners, co-ordinates the treatment of patients with chronic hepatitis C, and helps to facilitate interdisciplinary referrals within the multidisciplinary team. Conclusion: The introduction of the nurse practitioner model with the ability to prescribe specific medicines and initiate diagnostic investigations within approved clinical protocols can facilitate improved access to hepatitis C treatment programs. It is expected that the nurse practitioner’s expert knowledge and skill and the application of evidence based practice in the hepatitis specialty will assist in the provision of a safe, competent and high quality standard of care to patients.
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