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Improved care pathways increase number of UK patients treated for HCV
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Researchers from the United Kingdom have developed new care pathways that helped to improve the number of patients undergoing treatment for hepatitis C virus infection, according to study results published in Open Forum Infectious Diseases.
“This is the first study to provide unequivocal evidence that engagement with care pathways for patients with HCV infection in England can be improved,” Brian James Thomson, PhD, director of research and innovation at Nottingham University Hospitals NHS Trust, and colleagues wrote in their study. “These improvements demonstrated are likely to be a direct result of an intervention set designed to integrate and enhance the continuum of HCV care.”
Between 2010 and 2012, Thomson and colleagues evaluated 28,980 serum samples containing anti-HCV antibody and HCV-RNA from patients at the Microbiology Laboratory of the Nottingham University Hospitals NHS Trust. The study included 237 unique patients with a diagnosis of HCV infection. The researchers compared their results with a previous study of identical design and, after testing the serum samples, introduced a set of changes to local care pathways that included referring appropriate patients to specialty care clinics, providing educational programs for primary care physicians and nurses, and establishing community clinics for patients within substance abuse services.
The researchers found that 38% of patients had positive HCV results from general practice clinics, 23% in secondary care clinics, 21% in substance abuse services and 18% from the local prison population. Referrals improved from the baseline study: 80% of patients were referred to specialty clinics compared with 49% of patients in the baseline study, 70% of patients underwent assessment vs. 27%, and 38% underwent treatment vs. 10%, according to Thomson and colleagues.
The researchers noted that, while access to new and less toxic HCV treatments would increase the number of patients who undergo antiviral treatment, other challenges remain.
“The barriers to engagement with testing and treatment for HCV in disadvantaged populations are located in society, rather than solely pharmacological, and continue to be perceived as a major challenge to reducing the burden of HCV disease in the U.K.,” Thomson and colleagues wrote. – by Jeff Craven
Disclosure: The researchers report no relevant financial disclosures.
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