Early Successes in an Open Access, Provincially Funded Hepatitis C Treatment Program in Prince Edward Island.

INTRODUCTION: The availability of curative hepatitis C therapies has created an opportunity to improve treatment delivery and access. Local providers, government, industry, and community groups in Prince Edward Island developed an innovative province-wide care model. Our goal was to describe the first year of program implementation. MATERIAL AND METHODS: Using a communitybased prospective observational study design, all chronic hepatitis C referrals received from April 2015 to April 2016 were recorded in a database. Primary analysis assessed the time from referral to assessment/treatment, as well as the number of referrals, assessments, and treatment initiations. Secondary objectives included: (1) treatment effectiveness using intention-to-treat analysis; and (2) patient treatment experience assessed using demographics, adverse events, and medication adherence. RESULTS: During the study period 242 referrals were received, 123 patients were seen for intake assessments, and 93 initiated direct-acting antiviral therapy based on medical need. This is compared to 4 treatment initiations in the previous 2 years. The median time from assessment to treatment initiation was 3 weeks. Eighty-two of 84 (97.6%, 95% CI 91.7 - 99.7%) patients for whom outcome data were available achieved sustained virologic response at 12 weeks post-treatment; 1 was lost to follow-up and 1 died from an unrelated event. In the voluntary registry, 39.7% of patients reported missed treatment doses. CONCLUSION: In conclusion, results from the first 12 months of this multi-phase hepatitis C elimination strategy demonstrate improved access to treatment, and high rates of safe engagement and cure for patients living with chronic hepatitis C genotype 1 infections.

Early Successes in an Open Access, Provincially Funded Hepatitis C Treatment Program in Prince Edward Island.

INTRODUCTION: The availability of curative hepatitis C therapies has created an opportunity to improve delivery and access. Local providers, government, industry, and community groups in Prince Edward Island developed an innovative province-wide care model. Our goal was to describe the first year of program implementation. MATERIAL AND METHODS: Using a community based prospective observational study design, all chronic hepatitis C referrals received from April 2015 to April 2016 were recorded in a database. Primary analysis assessed the time from referral to assessment/treatment, as well as the number of referrals, assessments, and treatment initiations. Secondary objectives included: 1) Treatment effectiveness using intention-to-treat analysis; and 2) Patient treatment experience assessed using demographics, adverse events, and medication adherence. RESULTS: During the study period 242 referrals were received, 123 patients were seen for intake assessments, and 93 initiated direct-acting antiviral therapy based on medical need. This is compared to 4 treatment initiations in the previous 2 years. The median time from assessment to treatment initiation was 3 weeks. Eighty-two of 84 (97.6%, 95% CI 91.7 - 99.7%) patients for whom outcome data were available achieved sustained virologic response at 12 weeks post-treatment; 1 was lost to follow-up and 1 died from an unrelated event. In the voluntary registry, 39.7% of patients reported missed treatment doses. CONCLUSION: In conclusion, results from the first 12 months of this multi-phase hepatitis C elimination strategy demonstrate improved access to treatment, and high rates of safe engagement and cure for patients living with chronic hepatitis C genotype 1 infections.

Prince Edward Island: building capacity--the implementation of a critical care/emergency program.

Like other Canadian provinces, Prince Edward Island has a shortage of experienced nurses, especially in critical and emergency care. To increase the numbers of competent nurses, a PEI-based nursing course in these areas was identified as key to building capacity. This Research to Action pilot program successfully involved nurses in PEI-based emergency and critical care courses developed by the Nova Scotia Registered Nurses Professional Development Centre and funded by Human Resources and Skills Development Canada. The programs were offered on a full-time basis, lasted 14 weeks and included classroom and simulation laboratory time, along with a strong clinical component.Sixteen RNs graduated from the courses and became Advanced Cardiovascular Life Support (ACLS) certified. An additional 12 RNs were trained as preceptors. Feedback from participants indicates greater job satisfaction and increased confidence in providing patient assessments and care. Based on the program's success, the RTA partners proposed the establishment of an ongoing, PEI-based critical care and emergency nursing program utilizing 80/20 staffing models and mentorship. Their proposal was approved, with courses set to resume in January, 2012.

What do adults in Prince Edward Island know about nutrition?

PURPOSE: To assess adults' knowledge of dietary recommendations, food sources of key nutrients, food choices, and diet-disease relationships. METHODS: A previously validated survey, designed to assess nutrition knowledge, was adapted for use in Prince Edward Island and mailed to a random sample of 3,500 adults (aged 18 to 74). Dillman's Total Design Method was followed and a response rate of 26.4% achieved. Mean scores and 95% confidence intervals (CIs) were calculated for the overall survey and for each section. Demographic variations were assessed by univariate analysis. RESULTS: Of an overall possible score of 110 points, the mean score with 95% CI was 71.0 (70.1, 71.9). Respondents scored higher on the sections on dietary recommendations, food sources, and food choices than diet-disease relationships. Demographic differences existed in gender, age, education, and income. Findings suggest that adults have good general knowledge of dietary recommendations, but lack knowledge about how to make healthier food choices and the impact of diet on disease risk. CONCLUSION: When designing intervention strategies, dietitians should consider targeted messages to provide adults with the information they need to make healthy food choices.

Widespread micronutrient inadequacies among adults in prince edward island.

PURPOSE: The prevalence of micronutrient inadequacies was assessed among adult residents of Prince Edward Island (PEI) in the PEI Nutrition Survey. METHODS: A peer-reviewed protocol was used in this cross-sectional survey, in which 24-hour recalls were administered during in-home interviews. A stratified random sample of 1,995 adults aged 18 to 74 participated. Median nutrient intakes with and without supplements were calculated; intakes were adjusted for day-to-day variability. Chi-square testing was used to assess differences in prevalence of inadequacy by age and sex. RESULTS: Most of the sample (more than 90%) had folate intakes below the Estimated Average Requirement (EAR). Magnesium and vitamin C intakes were low in more than 50% of the sample. Iron intakes were adequate in all groups except women aged 19 to 50, 29% of whom had intakes below the EAR. Women were more likely than men to have inadequate intakes. Median calcium intakes fell below recommendations for all age and sex groups. Supplement use had little impact on dietary adequacy in this sample. CONCLUSIONS: This study underscores the need for public health interventions designed to reduce the very high prevalence of nutrient inadequacies in the PEI adult population. In addition, education is needed on the selection of appropriate vitamin and mineral supplements.

Stakeholder evaluation of a high-risk prenatal nutrition intervention program in Prince Edward Island.

Since 1971, a Prince Edward Island prenatal program has provided nutrition support to pregnant women at high risk for poor birth outcomes. Provincial changes in the delivery of health care services since 1986 have caused concern that the program is becoming less effective. The current research was designed to evaluate stakeholders satisfaction with the program; it was part of a larger study conducted in 1998 and 1999 to evaluate overall program effectiveness. Nutritionists (n=9), referring health professionals (n=57), and clients (n=50) completed a survey. The results indicated that program satisfaction was high for all stakeholders. Perceived program strengths included the counselling approach, program quality, food and income supplements, and accessibility. Perceived program weaknesses included inadequate staff/time, administrative requirements, limited communication/awareness, the counselling approach, and difficulty contacting clients. Recommendations for improvement fall into four key areas: staff services, program delivery, the counselling approach, and communication. The findings suggest that the components of prenatal education considered important vary among clients and staff, and that the relationship developed between staff and clients during counselling is an important contributor to program success.