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Connecting patients notified with hepatitis C to treatment (CONNECT Study): A randomized controlled trial of active case management by a health department to support primary care practitioners.
Marukutira, Tafireyi; Barter, Rachel; Moore, Karen P; Hellard, Margaret E; Richmond, Jacqui; Turner, Kate; Pedrana, Alisa E; Melody, Shannon; Johnston, Fay H; Owen, Louise; Boom, Wijnand van Den; Scott, Nick; Thompson, Alexander; Iser, David M; Spelman, Timothy; Veitch, Mark; Stoové, Mark; Doyle, Joseph S.
Afiliação
  • Marukutira T; Public Health, Burnet Institute, Melbourne, Victoria, Australia; Department of Epidemiology, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. Electronic address: tafireyi.marukutira@burnet.edu.au.
  • Barter R; Department of Health, Hobart, Tasmania, Australia.
  • Moore KP; Department of Health, Hobart, Tasmania, Australia.
  • Hellard ME; Public Health, Burnet Institute, Melbourne, Victoria, Australia.
  • Richmond J; Public Health, Burnet Institute, Melbourne, Victoria, Australia.
  • Turner K; Department of Health, Hobart, Tasmania, Australia.
  • Pedrana AE; Public Health, Burnet Institute, Melbourne, Victoria, Australia; Department of Epidemiology, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Melody S; Public Health, Burnet Institute, Melbourne, Victoria, Australia.
  • Johnston FH; Department of Health, Hobart, Tasmania, Australia.
  • Owen L; Department of Health, Hobart, Tasmania, Australia.
  • Boom WVD; Public Health, Burnet Institute, Melbourne, Victoria, Australia.
  • Scott N; Public Health, Burnet Institute, Melbourne, Victoria, Australia.
  • Thompson A; Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
  • Iser DM; Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
  • Spelman T; Public Health, Burnet Institute, Melbourne, Victoria, Australia.
  • Veitch M; Department of Health, Hobart, Tasmania, Australia.
  • Stoové M; Public Health, Burnet Institute, Melbourne, Victoria, Australia.
  • Doyle JS; Public Health, Burnet Institute, Melbourne, Victoria, Australia; Department of Infectious Diseases, Alfred Hospital, Melbourne, Victoria, Australia.
Int J Drug Policy ; 121: 104184, 2023 Nov.
Article em En | MEDLINE | ID: mdl-37714008
BACKGROUND: Despite subsidised access to direct-acting antivirals (DAAs), hepatitis C (HCV) treatment uptake in Australia is declining. Interventions are needed to link people living with HCV to care and treatment. We implemented and measured effectiveness of a state-wide, health department-led, enhanced case management through the primary care practitioner for all HCV notifications, aiming to encourage and support treatment commencement. METHODS: A randomised controlled trial compared enhanced case management, delivered by the health department to diagnosing clinicians, with standard of care using notifiable disease systems in Tasmania, Australia (2020-21). The intervention involved a nurse specialist contacting and providing support by telephone to primary care practitioners making an HCV notification. The primary outcome was the proportion of cases notified with chronic hepatitis C who commenced treatment within 12 weeks of notification. We allowed a 12-week extended follow-up period at the end of the study for participants with no outcomes. RESULTS: Eighty-five primary care practitioners randomised to the intervention and 86 to standard of care arms notified 111 and 115 HCV cases, respectively. The proportion of cases notified with chronic hepatitis (HCV RNA detected) commencing treatment within 12 weeks was similar between study arms (41% vs 33%; p=0·51) and after extended study follow-up (65% vs 48%; p=0·18). RNA test completion was higher in the intervention than in standard of care arm (89% vs. 78%; p=0·03), while completing pre-treatment workup for chronic patients (65% vs. 64%; p=0·93) was similar. CONCLUSION: This was the first prospective randomised study of the utility of immediate HCV notification follow-up of primary care practitioners to enhance treatment uptake using disease notification surveillance data. We demonstrated improvement in HCV RNA testing and trend toward better engagement in care, but no significant increase in treatment uptake.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Contexto em Saúde: 10_ODS3_salud_sexual_reprodutiva / 11_ODS3_cobertura_universal / 1_ASSA2030 / 2_ODS3 Problema de saúde: 10_sexually_transmitted_infections / 11_delivery_arrangements / 1_doencas_nao_transmissiveis / 1_doencas_transmissiveis / 2_enfermedades_transmissibles Assunto principal: Hepatite C / Hepatite C Crônica Tipo de estudo: Clinical_trials Limite: Humans Idioma: En Revista: Int J Drug Policy Assunto da revista: SAUDE PUBLICA / TRANSTORNOS RELACIONADOS COM SUBSTANCIAS Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Contexto em Saúde: 10_ODS3_salud_sexual_reprodutiva / 11_ODS3_cobertura_universal / 1_ASSA2030 / 2_ODS3 Problema de saúde: 10_sexually_transmitted_infections / 11_delivery_arrangements / 1_doencas_nao_transmissiveis / 1_doencas_transmissiveis / 2_enfermedades_transmissibles Assunto principal: Hepatite C / Hepatite C Crônica Tipo de estudo: Clinical_trials Limite: Humans Idioma: En Revista: Int J Drug Policy Assunto da revista: SAUDE PUBLICA / TRANSTORNOS RELACIONADOS COM SUBSTANCIAS Ano de publicação: 2023 Tipo de documento: Article
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