Broadening and strengthening the health providers caring for patients with chronic hepatitis C may improve continuity of care
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:...
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ftunivnewcastnsw:uon:54918 2024-04-21T08:02:08+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. George, Jacob Bollipo, Steven McGarity, Bruce Sievert, William MacQuillan, Gerry Tse, Edmund Nicoll, Amanda Wade, Amanda Cheng, Wendy Roberts, Stuart K. Strasser, Simone I. Weltman, Martin Thompson, Alex Levy, Miriam T. Leggett, Barbara Zekry, Amany Rong, Julian Sinclair, Marie The University of Newcastle. College of Health, Medicine & Wellbeing, School of Medicine and Public Health 2024 http://hdl.handle.net/1959.13/1500407 eng eng John Wiley & Sons Journal of Gastroenterology and Hepatology Vol. 39, Issue 3, p. 568-575 10.1111/jgh.16440 http://hdl.handle.net/1959.13/1500407 uon:54918 ISSN:0815-9319 x cirrhosis depression direct-acting antiviral fibrosis-4 scores hepatitis C virus injection drug use SDG 3 Sustainable Development Goals journal article 2024 ftunivnewcastnsw 2024-03-27T15:20:54Z 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 NOVA: The University of Newcastle Research Online (Australia) |
institution |
Open Polar |
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NOVA: The University of Newcastle Research Online (Australia) |
op_collection_id |
ftunivnewcastnsw |
language |
English |
topic |
cirrhosis depression direct-acting antiviral fibrosis-4 scores hepatitis C virus injection drug use SDG 3 Sustainable Development Goals |
spellingShingle |
cirrhosis depression direct-acting antiviral fibrosis-4 scores hepatitis C virus injection drug use SDG 3 Sustainable Development Goals Clark, Paul J. Valery, Patricia C. George, Jacob Bollipo, Steven McGarity, Bruce Sievert, William MacQuillan, Gerry Tse, Edmund Nicoll, Amanda Wade, Amanda Cheng, Wendy Roberts, Stuart K. Strasser, Simone I. Weltman, Martin Thompson, Alex Levy, Miriam T. Leggett, Barbara Zekry, Amany Rong, Julian Sinclair, Marie Broadening and strengthening the health providers caring for patients with chronic hepatitis C may improve continuity of care |
topic_facet |
cirrhosis depression direct-acting antiviral fibrosis-4 scores hepatitis C virus injection drug use SDG 3 Sustainable Development Goals |
description |
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 |
The University of Newcastle. College of Health, Medicine & Wellbeing, School of Medicine and Public Health |
format |
Article in Journal/Newspaper |
author |
Clark, Paul J. Valery, Patricia C. George, Jacob Bollipo, Steven McGarity, Bruce Sievert, William MacQuillan, Gerry Tse, Edmund Nicoll, Amanda Wade, Amanda Cheng, Wendy Roberts, Stuart K. Strasser, Simone I. Weltman, Martin Thompson, Alex Levy, Miriam T. Leggett, Barbara Zekry, Amany Rong, Julian Sinclair, Marie |
author_facet |
Clark, Paul J. Valery, Patricia C. George, Jacob Bollipo, Steven McGarity, Bruce Sievert, William MacQuillan, Gerry Tse, Edmund Nicoll, Amanda Wade, Amanda Cheng, Wendy Roberts, Stuart K. Strasser, Simone I. Weltman, Martin Thompson, Alex Levy, Miriam T. Leggett, Barbara Zekry, Amany Rong, Julian Sinclair, Marie |
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 |
John Wiley & Sons |
publishDate |
2024 |
url |
http://hdl.handle.net/1959.13/1500407 |
genre |
First Nations |
genre_facet |
First Nations |
op_relation |
Journal of Gastroenterology and Hepatology Vol. 39, Issue 3, p. 568-575 10.1111/jgh.16440 http://hdl.handle.net/1959.13/1500407 uon:54918 ISSN:0815-9319 |
op_rights |
x |
_version_ |
1796942338214330368 |