�Chronic Viral Hepatitis C Micro-Elimination Program Using Telemedicine. The Mexican Experience�

Hernández, José Luís; Tijera, María de Fátima Higuera de la; Salinas, César Alejandro Arce

doi:10.17235/reed.2021.7829/2021

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…Eleven articles report on HCV treatment outcomes through telehealth (Table 1), including remote specialist consultation, educational videos, and the support of primary care providers (five video telemedicine cases, four remote specialist consultations through teleconferences, one telephone consultation, and one paper-based referral followed by a fax or verbal discussion) [10][11][12][13][14][15][16][17][18][19][20].…”

Section: Hcv Treatment Outcomesmentioning

confidence: 99%

Telemedicine in Patients Affected by Chronic Liver Disease: A Scoping Review of Clinical Outcomes and the Devices Evaluated

Capuano

Hileman

Tigano

et al. 2023

JCM

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For patients with chronic liver disease (CLD), telemedicine is emerging as a useful tool to prevent liver decompensation or hospitalization, allowing access to and the decentralization of care, even for patients with limited resources. However, research and attendant evidence are still lacking; thus, this review aims to systematically explore the topic of telemonitoring for CLD to describe the currently used tools and clinical outcomes. The review was conducted by using key terms on PubMed/EMBASE and searching for observational studies or clinical trials (according to PRISMA recommendations) that were published between 6 April 2013 and 6 April 2023 to keep the technological framework limited to the last 10 years. The studies were described and grouped according to the aim of telemonitoring, the underlying disease, and the tools adopted to achieve remote monitoring. A total of 32 articles met the inclusion criteria. Of these, 11 articles report the successful use of a telehealth program to support and improve access to care in the management of HCV-related cirrhosis, eight articles examine the efficacy of telemedicine for remote monitoring interventions to prevent or decrease the risk of decompensation in high-risk patients, and five articles examine improvements in the physical performance and quality of life of cirrhotic patients through telehealth rehabilitation programs. Four studies were completed during the recent COVID-19 pandemic. Telehealth has the potential to provide and expand treatment access and reduce barriers to care for the most disadvantaged patients and might be able to reduce the need for hospital readmission for CLD, though most practice to test feasibility is still in the pilot stage.

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Section: Hcv Treatment Outcomesmentioning

confidence: 99%

Telemedicine in Patients Affected by Chronic Liver Disease: A Scoping Review of Clinical Outcomes and the Devices Evaluated

Capuano

Hileman

Tigano

et al. 2023

JCM

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“…Telemedicine-based models have been used more frequently in other settings to optimize the care cascade for HCV-infected patients [ 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ]. Recently, independent studies have shown how the support of telemedicine improve the access and management of antiviral treatment in the Department of Corrections, optimizing therapy effectiveness [ 47 , 48 , 49 , 50 , 51 , 52 , 53 ].…”

Section: Treatment Modelsmentioning

confidence: 99%

“…Similarly, telemedicine has also been successfully used to implement the HCV care cascade in remote areas, where the usual management and treatment models would have meant significant logistical difficulties, long waiting times, and high costs [ 54 , 55 , 56 , 57 , 58 ].…”

Section: Treatment Modelsmentioning

confidence: 99%

Can Telemedicine Optimize the HCV Care Cascade in People Who Use Drugs? Features of an Innovative Decentralization Model and Comparison with Other Micro-Elimination Strategies

Nevola

Rosato²,

Conturso³

et al. 2022

Biology

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People who use drugs (PWUDs) are a crucial population in the global fight against viral hepatitis. The difficulties in linkage to care, the low adherence to therapy, the frequent loss to follow-up and the high risk of re-infection make the eradication process of the hepatitis C virus (HCV) really hard in this viral reservoir. Several management and treatment models have been tested with the aim of optimizing the HCV care cascade in PWUDs. Models of decentralization of the care process and integration of services seem to provide the highest success rates. Giving this, telemedicine could favor the decentralization of diagnostic-therapeutic management, key for the implementation of linkage to care, reduction of waiting times, optimization of adherence and results and reduction of the costs. The purpose of this literature review is to examine the role and possible impact of telemedicine in optimizing the HCV care cascade, comparing the different care models that have shown to improve the linkage to care and therapeutic adherence in this special population.

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“…Simplifying algorithms to minimise the number of times patients must come to health facilities for care will be an important strategy. This may be done through same day screening and confirmatory VL; support via telemedicine21–23; and multimonth prescription dispensations, a strategy that has been used effectively in Cambodia to streamline number of visits for HCV patients,24 25 demonstrated strong SVR12 outcomes across five countries in the MINMON trial,26 and has also been used to streamline ART services for PLHIV. In addition, decentralising care to lower tier health facilities and additional cadres of HCW will improve access and has been shown to have equivalent SVR12 rates compared with care by specialists 27.…”

Section: Limitationsmentioning

confidence: 99%

Patient outcomes in public sector hepatitis C treatment programmes: a retrospective cohort analysis across five low- and middle-income countries

et al. 2022

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ObjectivesGiven limited data on factors associated with hepatitis C virus (HCV) treatment discontinuation and failure in low- and middle-income countries, we aimed to describe patient populations treated for HCV in five countries and identify patient groups that may need additional support.DesignRetrospective cohort analysis using routinely collected data.SettingPublic sector HCV treatment programmes in India (Punjab), Indonesia, Myanmar, Nigeria (Nasarawa) and Vietnam.Participants104 957 patients who initiated treatment in 2016–2022 (89% from Punjab).Primary outcomesTreatment completion and cure.ResultsPatient characteristics and factors associated with outcomes varied across countries and facilities. Across all patients, median age was 40 years (IQR: 29–52), 30.6% were female, 7.0% reported a history of injecting drugs, 18.2% were cirrhotic and 4.9% were coinfected with HIV. 79.8% were prescribed sofosbuvir+daclastasvir. Of patients with adequate follow-up, 90.6% (89,551) completed treatment. 77.5% (69,426) of those who completed treatment also completed sustained virological testing at 12 weeks (SVR12), and of those, 92.6% (64 305) were cured. In multivariable-adjusted models, in most countries, significantly lower treatment completion was observed among patients on 24-week regimens (vs 12-week regimens) and those initiated in later years of the programme. In several countries, males, younger patients <20 years and certain groups of cirrhotic patients were less likely to complete treatment or be cured. In Punjab, treatment completion was also lower in those with a family history of HCV and people who inject drugs (PWID); in other countries, outcomes were comparable for PWID.ConclusionHigh proportions of patients completed treatment and were cured across patient groups and countries. SVR12 follow-up could be strengthened. Males, younger people and those with decompensated cirrhosis on longer regimens may require additional support to complete treatment and achieve cure. Adequate programme financing, minimal user fees and implementation of evidence-based policies will be critical to close gaps.

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�Chronic Viral Hepatitis C Micro-Elimination Program Using Telemedicine. The Mexican Experience�

Cited by 4 publications

References 5 publications

Telemedicine in Patients Affected by Chronic Liver Disease: A Scoping Review of Clinical Outcomes and the Devices Evaluated

Telemedicine in Patients Affected by Chronic Liver Disease: A Scoping Review of Clinical Outcomes and the Devices Evaluated

Can Telemedicine Optimize the HCV Care Cascade in People Who Use Drugs? Features of an Innovative Decentralization Model and Comparison with Other Micro-Elimination Strategies

Patient outcomes in public sector hepatitis C treatment programmes: a retrospective cohort analysis across five low- and middle-income countries

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