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Increasing Treatment Rates for Hepatitis C in Primary Care.

Ann Stewart1, Amy Craig-Neil1, Kathryn Hodwitz1

  • 1From the Department of Family and Community Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada (AS, DC, GA, CJ, TK); Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada (AS, GA, CJ, TK); MAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada (AC, RW, TK); Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada (KH, CJ); Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada (CJ); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada (TK).

Journal of the American Board of Family Medicine : JABFM
|July 19, 2023
PubMed
Summary
This summary is machine-generated.

A primary care intervention improved Hepatitis C Virus (HCV) treatment initiation and success rates. The program boosted clinician confidence and skills, leading to more patients receiving curative treatment.

Keywords:
Family MedicineFocus GroupsHCV AntibodiesHepatitis CPharmacistsPhysiciansPrimary Health CareQuality ImprovementSustained Virologic Response

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Area of Science:

  • Hepatology
  • Primary Care Medicine
  • Public Health

Background:

  • Many individuals with Hepatitis C Virus (HCV) remain untreated despite curative antiviral therapies.
  • Primary care clinicians are crucial for HCV treatment but often lack specialized skills and confidence.

Purpose of the Study:

  • To assess the impact of a multifaceted improvement initiative on HCV treatment in primary care.
  • To evaluate the effect on treatment initiation rates and Sustained Virologic Response (SVR).

Main Methods:

  • A 10-month population-based intervention in primary care settings.
  • Intervention components included decision-support tools, clinician education, team support, mentorship, and patient outreach.
  • Process and outcome measures, physician focus groups, and pharmacist interviews were used.

Main Results:

  • Treatment initiation for HCV RNA positive patients increased from 66.0% to 75.5%.
  • Sustained Virologic Response (SVR) was achieved by 92.5% of those who started treatment.
  • Qualitative data indicated increased physician awareness and confidence, with key enablers including collaboration, education, mentorship, and integrated tools.

Conclusions:

  • A multifaceted primary care initiative effectively increased clinician confidence in managing HCV.
  • The intervention was associated with a significant rise in the proportion of patients initiating curative HCV treatment.