Integrating primary and secondary care to optimize hepatitis C treatment: development and evaluation of a multidisciplinary educational Masterclass series

Abstract

BackgroundIt is increasingly being recognized that the elimination of HCV requires a multidisciplinary approach and effective cooperation between primary and secondary care.ObjectivesAs part of a project (HepCare Europe) to integrate primary and secondary care for patients at risk of or infected with HCV, we developed a multidisciplinary educational Masterclass series for healthcare professionals (HCPs) working in primary care in Dublin and Bucharest. This article aims to describe and evaluate the series and examine how this model might be implemented into practice.MethodsGPs and other HCPs working in primary care, addiction treatment services and NGOs were invited to eight 1 day symposia (HCV Masterclass series), examining the burden and management of HCV in key populations. Peer-support sessions were also conducted, to give people affected by HCV and community-based organizations working with those directly affected, an update on the latest developments in HCV treatment.ResultsOne hundred percent of participants ‘strongly agreed’ or ‘agreed’ that the Masterclass helped them to appreciate the role of integrated services in ‘the management of patients with HCV’. One hundred percent of participants indicated the importance of a ‘designated nurse to liaise with hospital services’. An improvement of knowledge regarding HCV management of patients with high-risk behaviour was registered at the end of the course.ConclusionsIntegrated approaches to healthcare and improving the knowledge of HCPs and patients of the latest developments in HCV treatment are very important strategies that can enhance the HCV care pathway and treatment outcomes.

Integrating Hepatitis C Care for Opioid Substitution Treatment Patients Attending General Practice: Feasibility, Clinical, and Cost-Effectiveness Analysis

“…A pre- and postintervention design with an embedded economic analysis was used to establish the feasibility, acceptability, and clinical and cost-effectiveness of a complex intervention to optimize HCV identification and linkage to HCV treatment among patients on OST in primary care in North Dublin [ 23 ]. A sample of 24 OST-prescribing GP practices were invited to participate in the study from the professional networks of members of the research consortium and from those GPs who attended a series of educational masterclasses on “Advances in Hepatitis C Treatment in the Community.” This masterclass symposium series highlighted the benefits of educational seminars as a way of delivering current best practice in the treatment of HCV infection to a multidisciplinary audience and a useful vehicle for recruiting general practices to the study [ 24 ].…”

“…The complex intervention was delivered to the 14 primary care sites and consisted of outreach by a specialist HCV nurse into primary care sites to optimize interaction and integration between primary and secondary care. Informed by the HepCare Europe Education Masterclass series [ 24 ], the nurse provided HCV education, clinical support, and community-based HCV evaluation of patients. The protocol for clinical assessment by the nurse is described in Figure 1 .…”

HEPCARE EUROPE- A case study of a service innovation project aiming at improving the elimination of HCV in vulnerable populations in four European cities

“…PWID were targeted for intensified HCV screenings (HEPCHECK) (Swan et al, 2018;Cha et al, 2013), linked to care (HEPLINK) (McCombe et al, 2018) and supported to remain engaged with the cascade of care using peer support (HEPFRIEND) (McCombe et al, 2019). HEPED developed and delivered educational interventions to prepare affected communities for HCV testing, assessment, and treatment and prepare healthcare providers to act as partners in a shared care primary/secondary partnership to treat HCV (McCombe et al, 2019). HEPCOST evaluated the cost of the various Hepcare interventions in different settings.…”

Aspects that weaken access of people with viral hepatitis to healthcare services

“…6 International experiences cite the expansion of clinical training with the supervision of specialists, 47 in addition to the participation of nursing in consolidating advanced practice guidelines. 48 The role of nurses inserted in the conduction of the care model has shown that the responses are promising and positive, as in the HepCare Europe program, 49 and in countries such as Australia, 50 New Zealand, 51 and the U.S. state of Maryland. 52 Telehealth has been used to strengthen clinical decisionmaking on hepatitis therapeutic management and training, to advance the continuing education proposal, and to show the opportunities for virtual integration into treatment monitoring.…”