Asynchronous electronic consultation between primary care and specialized care proved effective for continuum of care for viraemic hepatitis C patients.
Gastroenterol Hepatol
; 46(4): 266-273, 2023 Apr.
Article
em En, Es
| MEDLINE
| ID: mdl-35964811
ABSTRACT
INTRODUCTION:
It has been proposed that primary care diagnose and treat hepatitis C virus (HCV) infection. However, a care circuit between primary and specialized care based on electronic consultation (EC) can be just as efficient in the micro-elimination of HCV. It is proposed to study characteristics and predictive factors of continuity of care in a circuit between primary and specialized care.METHODS:
From February/2018 to December/2019, all EC between primary and specialized care were evaluated and those due to HCV were identified. Variables for regression analysis and to identify predictors of completing the care cascade were recorded.RESULTS:
From 8098 EC, 138 were performed by 89 (29%) general practitioners over 118 patients (median 50.8 years; 74.6% men) and were related to HCV (1.9%). Ninety-two patients (78%) were diagnosed>6 months ago, and 26.3% met criteria for late presentation. Overall, 105 patients required assessment by the hepatologist, 82% (n=86) presented for the appointment, of which 67.6% (n=71) were viraemic, 98.6% of known. Finally, 61.9% (n=65) started treatment. Late-presenting status was identified as an independent predictor to complete the care cascade (OR 1.93, CI 1.71-1.99, p<0.001).CONCLUSION:
Communication pathway between Primary and Specialized Care based on EC is effective in avoiding significant losses of viraemic patients. However, the referral rate is very low, high in late-stage diagnoses, heterogeneous, and low in new diagnoses. Therefore, early detection strategies for HCV infection in primary care are urgently needed.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
11_ODS3_cobertura_universal
/
2_ODS3
Problema de saúde:
11_delivery_arrangements
/
2_enfermedades_transmissibles
Assunto principal:
Hepatite C
/
Consulta Remota
/
Hepatite C Crônica
Tipo de estudo:
Prognostic_studies
/
Screening_studies
Limite:
Female
/
Humans
/
Male
Idioma:
En
/
Es
Revista:
Gastroenterol Hepatol
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Espanha