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Ann Hepatol ; 17(2): 223-231, 2018.
Article de Anglais | MEDLINE | ID: mdl-31097237

RÉSUMÉ

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.


Sujet(s)
Antiviraux/économie , Antiviraux/usage thérapeutique , Services de santé communautaires/économie , Prestation intégrée de soins de santé/économie , Coûts des médicaments , Accessibilité des services de santé/économie , Hepacivirus/effets des médicaments et des substances chimiques , Hépatite C chronique/traitement médicamenteux , Hépatite C chronique/économie , Adulte , Sujet âgé , Antiviraux/effets indésirables , Bases de données factuelles , Femelle , Génotype , Hepacivirus/génétique , Hépatite C chronique/diagnostic , Hépatite C chronique/épidémiologie , Humains , Mâle , Adulte d'âge moyen , Ile-du-Prince-Édouard/épidémiologie , Évaluation de programme , Études prospectives , Orientation vers un spécialiste/économie , Facteurs temps , Délai jusqu'au traitement/économie , Résultat thérapeutique , Jeune adulte
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