Telemedicine and specialised consultations in prisons. The example of HCV chronic hepatitis

Rodríguez, Conrado Fernández; Galán, G Jiménez

doi:10.4321/s1575-06202019000200001

Cited by 1 publication

(1 citation statement)

References 13 publications

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“…15 HCV remains a significant healthcare burden amongst the prison populations and ethnic minorities, with TH initiatives making these groups key international elimination targets. 16–18 In Australia, the HCV burden disproportionately affects ATSI communities and to overcome this, the ‘Close The Gap’ campaign is looking at novel ways to engage this cohort. 19,20 Whilst two Northern American-based cohort analyses have reported similar SVR12 rates amongst their TH and non-TH HCV patient groups (94.7% vs. 94.8%, p =0.99) and (55% vs. 43%, p = 0.36) respectively, the TH cohorts were found to complete treatment (78% vs. 53%, p = 0.03) and attend clinic appointments (0.61 vs. 0.07, p < 0.001) more frequently than non-TH cohorts.…”

Section: Discussionmentioning

confidence: 99%

A nurse-led, telehealth-driven hepatitis C management initiative in regional Victoria: Cascade of care from referral to cure

et al. 2021

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Introduction Elimination of hepatitis C virus stands as an unresolved World Health Organization target, and is associated with complications including cirrhosis and hepatocellular carcinoma. Hepatitis C virus management has been revolutionised following the widespread availability of direct-acting antiviral agents in Australia since 2016; however, large proportions of the population remain untreated. Telehealth-based service delivery is an accessible and effective alternative, and we aimed to assess qualitative and clinical outcomes in a clinical nurse consultant-led regional telehealth model. Methods A prospective cohort analysis of all patients referred to a Victorian regional hospital’s hepatitis C virus telehealth clinic between 1 April 2017 and 10 June 2020 was conducted. Data were collated from outpatient and electronic medical records. Results Fifty-five out of 71 referred patients were booked, with 44 patients (80%) attending at least one appointment. A history of alcohol use disorder and psychiatric comorbidity was seen in 25 (54%) and 24 (52%) patients, respectively. Twenty-one out of 24 (88%) eligible patients had direct-acting antiviral agent treatment and 14 out of 21 (67%) successfully completed the treatment. An average of 46.5 km, 54.6 min and $AUD30.70 was saved per patient for each visit. Observed benefits included: increased medical engagement, adherence to and completion of HCV treatment and cirrhosis monitoring. Telehealth-driven hepatocellular carcinoma surveillance was successful in the cirrhotic subgroup. Conclusion Clinical nurse consultant-led hepatitis C virus management via telehealth allows access to marginalised regional populations. Clinical outcomes were comparable to other cohorts with additional cost-benefit, efficiency gains and carbon footprint reduction amongst a previously unreported regional Victorian hepatitis C virus population.

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