Patients with hepatitis C lost to follow-up: ethical-legal aspects and search results

García, Irene Andaluz; Rueda, María del Mar Arcos; Vega, María Dolores Montero; Grau, P. Castillo; Martín-Carbonero, Luz; García-Samaniego, Javier; Portales, Miriam Romero; Sánchez, A; Arenzana, Carmen Busca; García, Juan González; Montes, Marisa; Martín, Antonio Olveira

doi:10.17235/reed.2020.7077/2020

Cited by 8 publications

(3 citation statements)

References 17 publications

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“…With both the strategies, patients could perceive a medical confidentiality breach. However, the basic principles of medical ethics were considered, 24 and it could be disregarded from a public health perspective, 25 given the advantages that early treatment of HCV confers in preventing disease progression 26 and cost-effectiveness. 27 In addition, regulators in our country have been clear about this ethical point and favorably encourage this reengagement approach.…”

Section: Discussionmentioning

confidence: 99%

Reengagement strategies for hepatitis C patients lost to follow-up: A randomized clinical trial

Morales-Arráez

Hernández-Bustabad

Castro

et al. 2023

Hepatology Communications

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Background and Aims: To achieve the World Health Organization’s goal of eliminating HCV by 2030, reengagement of lost to follow-up cases is mandatory. However, there is lack of evidence concerning the best strategy. Our study evaluated the effectiveness, efficiency, predictive factors, and costs of 2 different strategies. Methods: We identified patients positive for HCV antibodies without RNA requests from 2005 to 2018. Patients fulfilling trial criteria (NCT04153708) were randomized to (1) phone call or (2) letter of invitation to schedule an appointment, followed by switching strategy. Results: Three hundred forty-five patients among 1167 lost to follow-up were identified. An analysis of the first 270 randomized patients (72% male, 51±13 y) showed a higher contact rate in the mail than in the phone call strategy (84.5% vs. 50.3%). In the intention-to-treat analysis, no differences were found related to appointment attendance (26.5% vs. 28.5%). Regarding efficiency, 3.1 letters and 8 phone calls were needed to successfully link 1 patient (p<0.001) but dropped down to 2.3 phone calls if we only considered the first call attempt (p=0.008). Prior specialist’s evaluation and HCV testing in the predirect-acting antiviral era were the only factors associated with no showing up for the appointment. The cost per patient was €621.3 (2.5 quality-adjusted life-years) in the phone call strategy and €611.8 (2.4 quality-adjusted life-years) in the mail letter strategy. Conclusions: Reengagement of patients with HCV is feasible, and equally effective with similar costs in both strategies. The mail letter was more efficient, except when only 1 phone call was considered. Prior specialist’s evaluation and testing in the predirect-acting antiviral era were factors associated with nonattendance to the appointment.

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Section: Discussionmentioning

confidence: 99%

Reengagement strategies for hepatitis C patients lost to follow-up: A randomized clinical trial

Morales-Arráez

Hernández-Bustabad

Castro

et al. 2023

Hepatology Communications

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“…They position barriers to testing and treatment (including legal rights protections) as potentially unethical, arguing that 'not acting in the knowledge that an effective treatment is available could be considered as a failure to provide assistance' (Andaluz et al 2020). Similar rhetoric can be found in Australia.…”

Section: Theory and Methodsmentioning

confidence: 97%

“…However, both the rhetoric and operationalisation of consent are changing. In Spain, for example, Andaluz et al (2020) have argued that:…”

Section: Theory and Methodsmentioning

confidence: 99%

Becoming posthuman: hepatitis C, the race to elimination and the politics of remaking the subject

Seear

Lenton

2021

Health Sociology Review

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Hepatitis C has long been a public health problem in Australia. 'Revolutionary' new drugs with the potential to cure hepatitis C have now emerged. The Australian government has invested heavily in them, and has an ambitious goal to eliminate hepatitis C by 2030. Numerous shifts in policy and practice are required if the elimination agenda is to be realised. This paper explores the significance of these shifts. We ask: what is the race to elimination doing with the subject? We argue that the race to elimination can be understood, simultaneously, as: a product of posthuman forces, capable of being analysed using the theoretical tools made available via the posthuman turn; producing an intervention in what it means to be human; and generating a dilemma for people who use (or used) drugs, people with hepatitis C, and posthuman scholarship. In drawing out these issues, we aim to: trace the significant developments underway in hepatitis C medicine and raise awareness of them; encourage reflection on the consequences of these developments; and invite reflections on what might be lost when the human is remade by hepatitis C medicine.

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Recommendations for the integral diagnosis of chronic viral hepatitis in a single analytical extraction

Crespo¹,

Cabezas²,

Aguilera³

et al. 2023

Gastroenterología y Hepatología (English Edition)

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Patients with hepatitis C lost to follow-up: ethical-legal aspects and search results

Cited by 8 publications

References 17 publications

Reengagement strategies for hepatitis C patients lost to follow-up: A randomized clinical trial

Reengagement strategies for hepatitis C patients lost to follow-up: A randomized clinical trial

Becoming posthuman: hepatitis C, the race to elimination and the politics of remaking the subject

Recommendations for the integral diagnosis of chronic viral hepatitis in a single analytical extraction

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