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PCP Training Program Increased Number of Patients Receiving HCV Treatment
The implementation of programs to train primary care physicians to manage and treat hepatitis C virus infection more than doubled the expected number of patients receiving treatment, according to a report in Morbidity & Mortality Weekly Report.
The CDC funded programs in Utah and Arizona in September 2012 modeled after Project ECHO, which was developed by the University of New Mexico. Project ECHO used videoconferencing and case-based learning to improve primary care capacity in rural and underserved populations.
Through February 2014, 66 PCPs were enrolled to participate in the programs in Utah and Arizona, 93% of whom had no experience in treating HCV. The PCPs were trained in-person on HCV diagnosis and management, then participated in weekly "teleECHO "clinic sessions to present their patients with HCV and monitor their treatment with a team of specialists that included a hepatologist.
During the 17-month period, 280 unique cases of HCV were presented. The cases were primarily US-born, white baby boomers. More than 41% of cases had a history of injection drug use. Among the 280 patients, 46.1% started HCV treatment, most with an interferon-based regimen. According to the report, the percentage of patients starting treatment was more than double the number starting treatment in a recent CDC study.
With training and supervision by specialists, HCV antiviral treatment can be safely and effectively delivered in primary care settings, the researchers wrote. Additional safe and effective HCV therapies currently under development could provide new options for primary care clinicians to incorporate management of HCV infection into their practices. Collaborations with specialists will help primary care providers to begin to incorporate new treatments for HCV infection and will be an important measure for improving access and reducing barriers to treatment.