The balancing perspective of hard-to-reach hepatitis C patients who were lost to follow-up: A qualitative study

Kracht, Patricia A. M.; Arends, Joop E.; Hoepelman, Andy I. M.; Vervoort, Sigrid C. J. M.

doi:10.1371/journal.pone.0230756

Cited by 7 publications

(4 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Second, we encouraged patients during telephone call to undergo HCV testing and treatment. We failed to thoroughly investigate the reasons for patient refusal during telephone call; possible reasons include unstable housing or financial resources, concomitant psychiatric disease, or concern for COVID-19 infection in the hospital [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Retrieval of lost patients in the system for hepatitis C microelimination: a single-center retrospective study

Yen

Liu

et al. 2021

BMC Gastroenterol

View full text Add to dashboard Cite

Background Hepatitis C virus (HCV) is one of the major causes of chronic liver disease, cirrhosis, and liver cancer. Most of the infected people have no clinical symptoms. The current strategy for HCV elimination includes test and treatment. In this study, we aimed to evaluate the campaign for retrieving patients who were lost to follow-up, for subsequent re-evaluation. Methods From January 2020 to October 2020, patients who had prior tests for positive anti-HCV antibody in 2010–2018 in our hospital were enrolled for our patient callback campaign. Patients who had unknown HCV RNA status or no documented successful antiviral therapy history were selected for anti-HCV therapy re-evaluation. To facilitate patient referral in the hospital, we developed an electronic reminding system and called the candidate patients via telephone during the study period. Results Through the hospital electronic system, 3783 patients with positive anti-HCV antibody documentation were identified. Among them, 1446 (38.22%) had tested negative for HCV RNA or had anti-HCV therapy, thereby excluded. Of the 2337 eligible patients, 1472 (62.99%) were successfully contacted and called back during the study period for subsequent HCV RNA testing and therapy. We found that 42.19% of the patients had positive HCV RNA and 88% received subsequent anti-HCV therapy. Conclusions A significant number of patients with positive HCV serology were lost for HCV confirmatory test or therapy in the hospital. Therefore, this targeted HCV callback approach in the hospital is feasible and effective in achieving microelimination.

show abstract

Section: Discussionmentioning

confidence: 99%

Retrieval of lost patients in the system for hepatitis C microelimination: a single-center retrospective study

Yen

Liu

et al. 2021

BMC Gastroenterol

View full text Add to dashboard Cite

show abstract

“…The finding is understandable, as the distance between healthcare facilities and residences may contribute to loss to follow-up among people living with HCV [ 37 ]. Apart from attempting to locate and retrieve those who were lost to follow-up, it is crucial for physicians to address the social and psychological factors that may influence their attitudes toward treatment in the future [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Assessing feasibility of a modified same-day test-and-treat model for hepatitis C among rural people who inject drugs

Hassan

Chan

Nordin³

et al. 2023

Harm Reduct J

View full text Add to dashboard Cite

Background Despite advancements in hepatitis C virus (HCV) treatment, low uptake among hard-to-reach populations remains a global issue. The current study aimed to assess the feasibility of a modified same-day test-and-treat model in improving HCV care for people who inject drugs (PWID) living in resource-constrained rural areas. Methods A pilot study was conducted in four primary healthcare (PHC) centers in Malaysia. The model's key features included on-site HCV ribonucleic acid (RNA) testing using a shared GeneXpert® system; noninvasive biomarkers for cirrhosis diagnosis; and extended care to PWID referred from nearby PHC centers and outreach programs. The feasibility assessment focused on three aspects of the model: demand (i.e., uptake of HCV RNA testing and treatment), implementation (i.e., achievement of each step in the HCV care cascade), and practicality (i.e., ability to identify PWID with HCV and expedite treatment initiation despite resource constraints). Results A total of 199 anti-HCV-positive PWID were recruited. They demonstrated high demand for HCV care, with a 100% uptake of HCV RNA testing and 97.4% uptake of direct-acting antiviral treatment. The rates of HCV RNA positivity (78.4%) and sustained virologic response (92.2%) were comparable to standard practice, indicating the successful implementation of the model. The model was also practical, as it covered non-opioid-substitution-therapy-receiving individuals and enabled same-day treatment in 71.1% of the participants. Conclusions The modified same-day test-and-treat model is feasible in improving HCV care for rural PWID. The study finding suggests its potential for wider adoption in HCV care for hard-to-reach populations.

show abstract

“…This study represents the first attempt of Malaysia to revisit the national response to HCV and characterize the challenges to expanding the treatment coverage. As issues related to HCV care have been explored mainly from the patient perspective [ 22 – 26 ], this study also adds to the existing literature by addressing both supply- and demand-side barriers in the context of a tripartite partnership between the public health system, the criminal justice system and CSOs.…”

Section: Discussionmentioning

confidence: 99%

Barriers to scaling up hepatitis C treatment in Malaysia: a qualitative study with key stakeholders

et al. 2022

View full text Add to dashboard Cite

Background While the availability of generic direct-acting antivirals (DAAs) opens the door for large-scale treatment, the care for people living with hepatitis C virus (HCV) in Malaysia is shifting toward a tripartite partnership between the public health system, correctional settings and civil society organizations (CSOs). This study aimed to explore the barriers to scaling up HCV treatment in Malaysia from the perspective of key stakeholders. Methods Eighteen focus-group discussions (FGDs) were conducted with 180 individuals, who actively engaged in coordinating, executing or supporting the implementation of the national strategic plan for HCV. An analytical framework was adapted to guide the data collection and thematic analysis. It covered four key aspects of HCV treatment: geographical accessibility, availability, affordability and acceptability. Results Movement restrictions in times of coronavirus disease 2019 (COVID-19) outbreaks and being marginalized translated into barriers to treatment access in people living with HCV. Barriers to treatment initiation in health and correctional settings included limited staffing and capacity; disruption in material supply; silos mentality and unintegrated systems; logistical challenges for laboratory tests; and insufficient knowledge of care providers. Although no-cost health services were in place, concerns over transportation costs and productivity loss also continued to suppress the treatment uptake. Limited disease awareness, along with the disease-related stigma, further lowered the treatment acceptability. Conclusions This study disclosed a series of supply- and demand-side barriers to expanding the treatment coverage among people living with HCV in Malaysia. The findings call for strengthening inter-organizational collaborations to overcome the barriers.

show abstract

The balancing perspective of hard-to-reach hepatitis C patients who were lost to follow-up: A qualitative study

Cited by 7 publications

References 21 publications

Retrieval of lost patients in the system for hepatitis C microelimination: a single-center retrospective study

Retrieval of lost patients in the system for hepatitis C microelimination: a single-center retrospective study

Assessing feasibility of a modified same-day test-and-treat model for hepatitis C among rural people who inject drugs

Barriers to scaling up hepatitis C treatment in Malaysia: a qualitative study with key stakeholders

Contact Info

Product

Resources

About