Broadening and strengthening the health providers caring for patients with chronic hepatitis C may improve continuity of care
Abstract Background Direct‐acting antiviral (DAA) therapies for hepatitis C virus infection (HCV) lead to excellent rates of sustained virological response (SVR). However, loss to follow‐up (LTFU) for SVR testing remains a challenge. We examine factors associated with LTFU in a real‐world setting. M...
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Online Access: | http://dx.doi.org/10.1111/jgh.16440 https://onlinelibrary.wiley.com/doi/pdf/10.1111/jgh.16440 |
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crwiley:10.1111/jgh.16440 2024-04-07T07:52:30+00:00 Broadening and strengthening the health providers caring for patients with chronic hepatitis C may improve continuity of care Clark, Paul J Valery, Patricia C Strasser, Simone I Weltman, Martin Thompson, Alex Levy, Miriam T Leggett, Barbara Zekry, Amany Rong, Julian Sinclair, Marie George, Jacob Bollipo, Steven McGarity, Bruce Sievert, William MacQuillan, Gerry Tse, Edmund Nicoll, Amanda Wade, Amanda Cheng, Wendy Roberts, Stuart K Gastroenterological Society of Australia Gilead Sciences Merck AbbVie 2023 http://dx.doi.org/10.1111/jgh.16440 https://onlinelibrary.wiley.com/doi/pdf/10.1111/jgh.16440 en eng Wiley http://creativecommons.org/licenses/by-nc/4.0/ Journal of Gastroenterology and Hepatology volume 39, issue 3, page 568-575 ISSN 0815-9319 1440-1746 Gastroenterology Hepatology journal-article 2023 crwiley https://doi.org/10.1111/jgh.16440 2024-03-08T03:54:40Z Abstract Background Direct‐acting antiviral (DAA) therapies for hepatitis C virus infection (HCV) lead to excellent rates of sustained virological response (SVR). However, loss to follow‐up (LTFU) for SVR testing remains a challenge. We examine factors associated with LTFU in a real‐world setting. Methods Adults who received DAA therapy for HCV in one of 26 centers across Australia during 2016–2021 were followed up for 2 years. Data sources included the patient medical records and the national Pharmaceutical and Medicare Benefits Schemes. Linkage to Medicare provided utilization data of other health‐care providers and re‐treatment with DAAs. LTFU was defined as no clinic attendance for SVR testing by at least 52 weeks after DAA treatment commencement. Multivariable logistic regression assessed factors associated with LTFU. Results In 3619 patients included in the study (mean age 52.0 years; SD = 10.5), 33.6% had cirrhosis (69.4% Child–Pugh class B/C), and 19.3% had HCV treatment prior to the DAA era. Five hundred and fifteen patients (14.2%) were LTFU. HCV treatment initiation in 2017 or later (adj‐OR = 2.82, 95% confidence interval [CI] 2.25–3.54), younger age (adj‐OR = 2.63, 95% CI 1.80–3.84), Indigenous identification (adj‐OR = 1.99, 95% CI 1.23–3.21), current injection drug use or opioid replacement therapy (adj‐OR = 1.66, 95% CI 1.25–2.20), depression treatment (adj‐OR = 1.49, 95% CI 1.17–1.90), and male gender (adj‐OR = 1.31, 95% CI 1.04–1.66) were associated with LTFU. Conclusions These findings stress the importance of strengthening the network of providers caring for patients with HCV. In particular, services targeting vulnerable groups of patients such as First Nations Peoples, youth health, and those with addiction and mental health disorders should be equipped to treat HCV. Article in Journal/Newspaper First Nations Wiley Online Library Journal of Gastroenterology and Hepatology 39 3 568 575 |
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English |
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Gastroenterology Hepatology |
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Gastroenterology Hepatology Clark, Paul J Valery, Patricia C Strasser, Simone I Weltman, Martin Thompson, Alex Levy, Miriam T Leggett, Barbara Zekry, Amany Rong, Julian Sinclair, Marie George, Jacob Bollipo, Steven McGarity, Bruce Sievert, William MacQuillan, Gerry Tse, Edmund Nicoll, Amanda Wade, Amanda Cheng, Wendy Roberts, Stuart K Broadening and strengthening the health providers caring for patients with chronic hepatitis C may improve continuity of care |
topic_facet |
Gastroenterology Hepatology |
description |
Abstract Background Direct‐acting antiviral (DAA) therapies for hepatitis C virus infection (HCV) lead to excellent rates of sustained virological response (SVR). However, loss to follow‐up (LTFU) for SVR testing remains a challenge. We examine factors associated with LTFU in a real‐world setting. Methods Adults who received DAA therapy for HCV in one of 26 centers across Australia during 2016–2021 were followed up for 2 years. Data sources included the patient medical records and the national Pharmaceutical and Medicare Benefits Schemes. Linkage to Medicare provided utilization data of other health‐care providers and re‐treatment with DAAs. LTFU was defined as no clinic attendance for SVR testing by at least 52 weeks after DAA treatment commencement. Multivariable logistic regression assessed factors associated with LTFU. Results In 3619 patients included in the study (mean age 52.0 years; SD = 10.5), 33.6% had cirrhosis (69.4% Child–Pugh class B/C), and 19.3% had HCV treatment prior to the DAA era. Five hundred and fifteen patients (14.2%) were LTFU. HCV treatment initiation in 2017 or later (adj‐OR = 2.82, 95% confidence interval [CI] 2.25–3.54), younger age (adj‐OR = 2.63, 95% CI 1.80–3.84), Indigenous identification (adj‐OR = 1.99, 95% CI 1.23–3.21), current injection drug use or opioid replacement therapy (adj‐OR = 1.66, 95% CI 1.25–2.20), depression treatment (adj‐OR = 1.49, 95% CI 1.17–1.90), and male gender (adj‐OR = 1.31, 95% CI 1.04–1.66) were associated with LTFU. Conclusions These findings stress the importance of strengthening the network of providers caring for patients with HCV. In particular, services targeting vulnerable groups of patients such as First Nations Peoples, youth health, and those with addiction and mental health disorders should be equipped to treat HCV. |
author2 |
Gastroenterological Society of Australia Gilead Sciences Merck AbbVie |
format |
Article in Journal/Newspaper |
author |
Clark, Paul J Valery, Patricia C Strasser, Simone I Weltman, Martin Thompson, Alex Levy, Miriam T Leggett, Barbara Zekry, Amany Rong, Julian Sinclair, Marie George, Jacob Bollipo, Steven McGarity, Bruce Sievert, William MacQuillan, Gerry Tse, Edmund Nicoll, Amanda Wade, Amanda Cheng, Wendy Roberts, Stuart K |
author_facet |
Clark, Paul J Valery, Patricia C Strasser, Simone I Weltman, Martin Thompson, Alex Levy, Miriam T Leggett, Barbara Zekry, Amany Rong, Julian Sinclair, Marie George, Jacob Bollipo, Steven McGarity, Bruce Sievert, William MacQuillan, Gerry Tse, Edmund Nicoll, Amanda Wade, Amanda Cheng, Wendy Roberts, Stuart K |
author_sort |
Clark, Paul J |
title |
Broadening and strengthening the health providers caring for patients with chronic hepatitis C may improve continuity of care |
title_short |
Broadening and strengthening the health providers caring for patients with chronic hepatitis C may improve continuity of care |
title_full |
Broadening and strengthening the health providers caring for patients with chronic hepatitis C may improve continuity of care |
title_fullStr |
Broadening and strengthening the health providers caring for patients with chronic hepatitis C may improve continuity of care |
title_full_unstemmed |
Broadening and strengthening the health providers caring for patients with chronic hepatitis C may improve continuity of care |
title_sort |
broadening and strengthening the health providers caring for patients with chronic hepatitis c may improve continuity of care |
publisher |
Wiley |
publishDate |
2023 |
url |
http://dx.doi.org/10.1111/jgh.16440 https://onlinelibrary.wiley.com/doi/pdf/10.1111/jgh.16440 |
genre |
First Nations |
genre_facet |
First Nations |
op_source |
Journal of Gastroenterology and Hepatology volume 39, issue 3, page 568-575 ISSN 0815-9319 1440-1746 |
op_rights |
http://creativecommons.org/licenses/by-nc/4.0/ |
op_doi |
https://doi.org/10.1111/jgh.16440 |
container_title |
Journal of Gastroenterology and Hepatology |
container_volume |
39 |
container_issue |
3 |
container_start_page |
568 |
op_container_end_page |
575 |
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1795667880154497024 |