Abstract
BackgroundAustralia is committed to eliminating the hepatitis C virus (HCV) by 2030. Despite regulations in Australia that enable the prescription of subsidised direct acting antiviral (DAA) by primary health care providers, the number of providers who treat patients for HCV remains low and this limits the prospect of HCV elimination. The Prince Charles Hospital, Brisbane, Australia, implemented an innovative program called Cure-It aimed at engaging primary care providers in community-based HCV treatment. This paper aims to describe initial experiences and short-term patient outcomes of this program.MethodsA formative evaluation was conducted using program data for the period March 2016 to April 2018. Descriptive statistics were used to report the number of engaged primary care providers, patients’ baseline characteristics, treatment plans, and treatment outcomes.ResultsThirty primary care providers from different settings were engaged in HCV treatment. Among 331 patients eligible for community-based treatment, 315 (95.2%) commenced treatment, the completion rate was 92.4 and 66.5% achieved sustained virological response at 12 weeks (SVR12). The SVR12 had not been documented for 26.8% of patients. Among patients whose SVR12 was documented, 98.2% achieved SVR12. Only 1.3% of patients experienced treatment failure.ConclusionA flexible tertiary-led model can improve primary care providers and patients’ engagement with provision of HCV treatment. Tertiary centres need to play their role to improve the accessibility of HCV treatment through providing training and on-going support for primary care providers while enabling those providers to become more confident in providing treatment independently.
Highlights
Australia is committed to eliminating the hepatitis C virus (HCV) by 2030
Between March 2016 and April 2018, one Addiction Specialist, one Nurse practitioner (NP) and four General practitioner (GP) from four different drug and alcohol services and 24 GPs practising in private practices used the training and support provided through the CureIt program to initiate HCV treatment
21 GPs were approached after they referred patients to the hospital and two of them (9.5%) refused to provide HCV treatment
Summary
Despite regulations in Australia that enable the prescription of subsidised direct acting antiviral (DAA) by primary health care providers, the number of providers who treat patients for HCV remains low and this limits the prospect of HCV elimination. Pourmarzi et al BMC Public Health (2019) 19:1335 To help further this aspirational goal, DAAs were listed in the Australian Pharmaceutical Benefits Scheme (PBS) in March 2016, allowing subsidised access to treatment for all patients with HCV. GPs and NPs who are not experienced in HCV management need to consult with a specialist to prescribe DAAs. To receive specialists’ advice and approval for HCV treatment initiation, primary care providers need to submit a ‘remote consultation form’ to specialists [4]
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