The Need to Promote Hepatitis C Care
Knowledge gaps
Through our research and network feedback we determined that most patients receive their HCV care (with the exception of specialist-based anti-viral therapy) in primary care and community-based organizations where inadequate knowledge of HCV is well documented [1]. These knowledge deficits, which are amenable to educational interventions and service integration, contribute to the significant gap in patient uptake of services and engagement in care throughout the disease course [2].
Reducing inequities
Strengthening patient self care and primary health services is one of the most important means of reducing inequities for disadvantaged populations and can improve population health outcomes, including reduced risk and effects of acute and chronic conditions; reduced use of emergency services; lower rates of preventable hospital admissions; and lower overall health care utilization [3, 4]. At the primary care level, improved patient self care and engagement for HCV disease monitoring and management can improve overall health, prevent excess morbidity and ensure timely referrals for specialist consultation and treatment.
Non-attendance for specialist care
At the specialist level, over 50% of those referred do not attend for the initial consultation contributing to the low HCV treatment uptake of less than 15% of those affected and of those less than 50% would have been cured [5-7].
Emerging therapies
Emergent therapies could cure over 90%, reduce excess morbidity and prevent premature death thus reducing the population and individual burden of the disease [8]. Our work to date has shown that with adequate support and educational information more patients will successfully engage in primary care, specialty services and treatment.
References
- Cox, J., et al., Knowledge, attitudes and behaviours associated with the provision of hepatitis C care by Canadian family physicians. Journal of Viral Hepatitis, 2011. 18(7): p. e332-e340.
- Butt, G., et al., Reasons for Nonattendance across the Hepatitis C Disease Course, in ISRN Nursing. 2013. p. 10.
- Lavoie, J.G., et al., Have investments in on-reserve health services and initiatives promoting community control improved First Nations health in Manitoba? Social Science & Medicine, 2010. 71(4): p. 717-724.
- World Health Organization, The World Health Report 2008- Primary Health Care (Now More than Ever). 2008, World Health Organization: Geneva.
- Butt, A.A., et al., Reasons for non-treatment of hepatitis C in veterans in care. Journal of Viral Hepatitis, 2005. 12(1): p. 81-85.
- Cawthorne, C.H., et al., Limited success of HCV antiviral therapy in United States veterans. The American Journal of Gastroenterology, 2002. 97(1): p. 149-155.
- Groom, H., et al., Outcomes of a Hepatitis C Screening Program at a Large Urban VA Medical Center. Journal of Clinical Gastroenterology, 2008. 42(1): p. 97-106.
- Kohli A, Shaffer A, Sherman A, Kottilil S. Treatment of Hepatitis C: A Systematic Review. JAMA. 2014;312(6):631-640. doi:10.1001/jama.2014.7085.
