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Using notifications data to increase hepatitis C testing and treatment rates in Queensland
Morris Carpenter1, Linda A Selvey2, Stephen B Lambert3
1School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland 4006. m.carpenter@uq.edu.au.
Communicable Diseases Intelligence (2018)
|October 19, 2023
Summary
Following up hepatitis C notifications in Queensland increased treatment rates, but the process was resource-intensive and highlighted the need for better continuity of care between hospitals and the community.
Area of Science:
- Hepatology
- Public Health
- Infectious Diseases
Background:
- Australia aims to eliminate hepatitis C by 2030, necessitating improved testing and treatment access.
- Hepatitis C virus (HCV) infection is a notifiable condition, providing health departments with data on exposed individuals and their clinicians.
- Distinguishing between active infection (HCV RNA testing) and prior exposure (antibody testing) is crucial for treatment decisions.
Purpose of the Study:
- To pilot a follow-up system for hepatitis C notifications in Queensland to boost HCV RNA testing and treatment uptake.
- To assess the effectiveness and challenges of a clinician-led follow-up process for individuals with new hepatitis C notifications.
Main Methods:
- A pilot project in Queensland tracked first-time hepatitis C notifications between November 2020 and May 2021, excluding prison cases.
- Laboratories were queried for subsequent HCV RNA testing; notifications without identified RNA tests were followed up via the notifying clinician.
- Clinician interviews were conducted to understand the follow-up process and identify barriers and facilitators.
Main Results:
- Of 769 new notifications, 244 required follow-up. Of these, 134 were lost, 26 were managed, 22 had prior treatment, and 62 were eligible for HCV RNA testing.
- Twenty-six individuals subsequently commenced hepatitis C treatment.
- 34% of notifications requiring follow-up originated from hospital-based testing, underscoring the need for improved hospital-to-community care coordination.
Conclusions:
- Following up hepatitis C notifications can increase treatment rates but is resource-intensive.
- The pilot highlighted challenges in clinician-patient contact and the critical need for enhanced continuity of care between hospital and community settings.
- Strategies to improve follow-up and ensure sustained patient engagement are essential for hepatitis C elimination goals.
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