在初级保健中增加C型肝炎治疗率
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).
一个初级保健干预改善了C型肝炎病毒 (HCV) 治疗启动率和成功率. 该计划提高了临床医生的信心和技能,导致更多的患者接受治疗治疗.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 主要护理医学 医疗保健
- 公共卫生 公共卫生
背景情况:
- 许多感染C型肝炎病毒 (HCV) 的人,尽管有治愈性抗病毒疗法,但仍未接受治疗.
- 初级保健医生对于HCV治疗至关重要,但往往缺乏专业技能和信心.
研究的目的:
- 评估多方面改进计划对初级保健中HCV治疗的影响.
- 评估对治疗开始率和持续病毒反应 (SVR) 的影响.
主要方法:
- 在初级保健机构进行为期10个月的基于人口的干预.
- 干预组件包括决策支持工具,临床医生教育,团队支持,指导和患者外展.
- 使用了过程和结果措施,医生焦点小组和药剂师访谈.
主要成果:
- 对HCVRNA阳性患者的治疗开始时间从66.0%增加到75.5%.
- 持续病毒反应 (SVR) 在开始治疗的患者中达到了92.5%.
- 定性数据表明,医生意识和信心增加,关键推动因素包括协作,教育,指导和综合工具.
结论:
- 一个多方面的初级保健计划有效地提高了临床医生的对控制HCV的信心.
- 这项干预与开始治疗HCV治疗的患者比例显著增加有关.
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