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Hepatitis C treatment in a co-located mental health and alcohol and drug service using a nurse-led model of care.
Harney, Brendan L; Brereton, Rebecca; Whitton, Bradley; Pietrzak, Danusia; Paige, Emma; Roberts, Stuart K; Birks, Susanne; Saraf, Sudeep; Hellard, Margaret E; Doyle, Joseph S.
Afiliación
  • Harney BL; Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Vic, Australia.
  • Brereton R; Disease Elimination Program, Burnet Institute, Melbourne, Vic, Australia.
  • Whitton B; St Kilda Road & Southcity Clinic, Alfred Community Mental & Addiction Health, Melbourne, Vic, Australia.
  • Pietrzak D; Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Vic, Australia.
  • Paige E; St Kilda Road & Southcity Clinic, Alfred Community Mental & Addiction Health, Melbourne, Vic, Australia.
  • Roberts SK; Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Vic, Australia.
  • Birks S; Department of Gastroenterology, Alfred Health, Melbourne, Vic, Australia.
  • Saraf S; Department of Medicine, Monash University, Melbourne, Vic, Australia.
  • Hellard ME; St Kilda Road & Southcity Clinic, Alfred Community Mental & Addiction Health, Melbourne, Vic, Australia.
  • Doyle JS; St Kilda Road & Southcity Clinic, Alfred Community Mental & Addiction Health, Melbourne, Vic, Australia.
J Viral Hepat ; 28(5): 771-778, 2021 05.
Article en En | MEDLINE | ID: mdl-33599036
ABSTRACT
Hepatitis C virus (HCV) is more prevalent among people with experience of severe mental illness compared to the general population, due in part to higher levels of injecting drug use. Delivering HCV care through mental health services may reduce barriers to care and improve outcomes. A nurse-led HCV program was established in a co-located mental health and addiction service in Melbourne, Australia. People with a history of injecting drug use, including current use, were referred for HCV testing by nurses, with support provided on-site from a general practitioner and remotely from infectious disease and hepatology specialists. A nurse practitioner, general practitioner or specialists were able to prescribe HCV treatment. One-hundred and thirty people were referred to the nurse-led service, among whom 112 (86%) were engaged in care. Of those 112, 84 (75%) were found to have detectable HCV RNA, 70 (83%) commenced treatment; 28 (40%) prescriptions were nurse initiated, 19 (27%) were general practitioner initiated and 20 (29%) were prescribed from hospital clinics or elsewhere. All people with an SVR result (48/70) achieved HCV cure (intention to treat SVR 69%, per-protocol SVR 100%). Treatment commencement was highest among people prescribed opioid agonist therapy (28/29, 96%) compared to those who were not (18/26, 69%). In conclusion, a nurse-led, HCV service for people with severe mental illness including pathways to specialist support when needed can achieve high treatment uptake and cure. Further implementation work is required to improve treatment uptake, particularly among people not prescribed opioid agonist therapy, and to improve follow-up for SVR testing.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Preparaciones Farmacéuticas / Abuso de Sustancias por Vía Intravenosa / Hepatitis C Tipo de estudio: Guideline / Prognostic_studies Límite: Humans Idioma: En Revista: J Viral Hepat Asunto de la revista: GASTROENTEROLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Australia

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Preparaciones Farmacéuticas / Abuso de Sustancias por Vía Intravenosa / Hepatitis C Tipo de estudio: Guideline / Prognostic_studies Límite: Humans Idioma: En Revista: J Viral Hepat Asunto de la revista: GASTROENTEROLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Australia