scholarly journals Improving Access to Care by Allowing Self-Referral to a Hepatitis C Clinic

2009 ◽  
Vol 23 (6) ◽  
pp. 421-424 ◽  
Author(s):  
Karen Doucette ◽  
Vicki Robson ◽  
Stephen Shafran ◽  
Dennis Kunimoto
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Hepatitis C ◽  
Access To Care ◽  
Support Program ◽  
Genotype 1 ◽  
Hcv Treatment ◽  
Similar Treatment ◽  
Primary Risk Factor ◽  
Improve Access

BACKGROUND: Estimates suggest that more than 250,000 Canadians are infected with hepatitis C virus (HCV), but less than 10% have been treated. Access to specialists in Canada is usually via health care professional (HCP) referral and, therefore, may be a barrier to HCV care. However, clinics that operate in conjunction with the Hepatitis Support Program, Edmonton, Alberta, allow self-referral. It is hypothesized that this improves access to care without increasing inappropriate referrals.OBJECTIVE: To compare the baseline characteristcs and outcomes of HCV patients who self-referred with those who were HCP-referred.METHODS: Data were collected from the Hepatitis Support Program HCV database and chart reviews.RESULTS: Between December 17, 2002, and December 31, 2007, 1563 patients were referred including 336 self- (21.5%) and 1227 HCP- referrals (78.5%). Self- and HCP-referred patients were similar in terms of age (mean [± SD] 43.0±10.3 years versus 43.9±10.0 years, respectively; P=0.18), sex (56.8% versus 62.0% [men], respectively; P=0.08) and risk factors for HCV (P=0.3), with 49.7% and 52.6%, respectively, identifying injection drug use as the primary risk factor. The two groups had similar HCV genotype distributions and liver biopsy fibrosis scores with similar treatment rates (31.3% versus 33.2%; P=0.6). Treatment outcomes were excellent (sustained virological response 40.2% for genotype 1, 67% for genotypes 2 and 3) in patients completing therapy and were similar between the two groups.Conclusion: Self-referred patients comprised 21.5% of patients accessing care in the clinic. Self- and HCP-referred patients had similar characteristics, treatment rates and outcomes. Facilitating self- referral to an HCV clinic can improve access to care, including risk reduction education and HCV treatment.

Telemedicine in Cancer Care

2018 ◽  
pp. 540-545 ◽  
Author(s):  
S. Joseph Sirintrapun ◽  
Ana Maria Lopez
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Cancer Care ◽  
Symptom Management ◽  
Lifestyle Modification ◽  
Clinical Settings ◽  
Home Based ◽  
Home Based Care ◽  
Care Costs ◽  
Improve Access

Telemedicine uses telecommunications technology as a tool to deliver health care to populations with limited access to care. Telemedicine has been tested in multiple clinical settings, demonstrating at least equivalency to in-person care and high levels of patient and health professional satisfaction. Teleoncology has been demonstrated to improve access to care and decrease health care costs. Teleconsultations may take place in a synchronous, asynchronous, or blended format. Examples of successful teleoncology applications include cancer telegenetics, bundling of cancer-related teleapplications, remote chemotherapy supervision, symptom management, survivorship care, palliative care, and approaches to increase access to cancer clinical trials. Telepathology is critical to cancer care and may be accomplished synchronously and asynchronously for both cytology and tissue diagnoses. Mobile applications support symptom management, lifestyle modification, and medication adherence as a tool for home-based care. Telemedicine can support the oncologist with access to interactive tele-education. Teleoncology practice should maintain in-person professional standards, including documentation integrated into the patient’s electronic health record. Telemedicine training is essential to facilitate rapport, maximize engagement, and conduct an accurate virtual exam. With the appropriate attachments, the only limitation to the virtual exam is palpation. The national telehealth resource centers can provide interested clinicians with the latest information on telemedicine reimbursement, parity, and practice. To experience the gains of teleoncology, appropriate training, education, as well as paying close attention to gaps, such as those inherent in the digital divide, are essential.

scholarly journals Alcohol and other drug treatment experiences of hepatitis C-positive and negative clients: implications for hepatitis C treatment

2009 ◽  
Vol 33 (1) ◽  
pp. 100 ◽  
Author(s):  
Loren Brener ◽  
Carla J Treloar
Keyword(s):  
Health Care ◽  
Hepatitis C ◽  
Drug Treatment ◽  
Health Care Workers ◽  
Differential Treatment ◽  
Treatment Facility ◽  
Hcv Treatment ◽  
Treatment Uptake ◽  
Care Workers ◽  
Treatment Facilities

To assess whether HCV-positive clients perceive that alcohol and other drug (AOD) staff discriminate against them, this study compared the treatment experiences of 120 HCV-positive clients with those of 120 HCV-negative clients attending the same AOD treatment facility. Despite the overall findings of favourable attitudes of HCV-positive clients toward their health care workers, these attitudes were less positive than those of their HCV-negative counterparts. Clients with HCV also rated their interpersonal treatment by their health care workers less favourably. These findings suggest that HCV-positive clients? attitudes towards their health care workers and their experiences of differential treatment by these health care workers might be a barrier to HCV treatment uptake in AOD treatment facilities.

scholarly journals From risk to care: the hepatitis C screening and diagnostic cascade in a primary health care clinic in Karachi, Pakistan—a cohort study

2018 ◽  
Vol 12 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Gul Ghuttai Khalid ◽  
Khine Wut Yee Kyaw ◽  
Christine Bousquet ◽  
Rosa Auat ◽  
Dmytro Donchuk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Primary Health Care ◽  
Hepatitis C ◽  
Early Stage ◽  
Informal Settlement ◽  
Cohort Analysis ◽  
Care Clinic ◽  
Primary Health Care Clinic ◽  
Primary Health

Abstract Background In the high-prevalence setting of Pakistan, screening, diagnosis and treatment services for chronic hepatitis C (CHC) patients are commonly offered in specialized facilities. We aimed to describe the cascade of care in a Médecins Sans Frontières primary health care clinic offering CHC care in an informal settlement in Karachi, Pakistan. Methods This was a retrospective cohort analysis using routinely collected data. Three different screening algorithms were assessed among patients with one or more CHC risk factors. Results Among the 87 348 patients attending the outpatient clinic, 5003 (6%) presented with one or more risk factors. Rapid diagnostic test (RDT) positivity was 38% overall. Approximately 60% of the CHC patients across all risk categories were in the early stage of the disease, with an aspartate aminotransferase:platelet ratio index score <1. The sequential delays in the cascade differed between the three groups, with the interval between screening and treatment initiation being the shortest in the cohort tested with GeneXpert onsite. Conclusions Delays between screening and treatment can be reduced by putting in place more patient-centric testing algorithms. New strategies, to better identify and treat the hidden at-risk populations, should be developed and implemented.

scholarly journals Distribution of Hepatitis C Risk Factors and HCV Treatment Outcomes among Central Canadian Aboriginal

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Parmvir Parmar ◽  
Daniel J. Corsi ◽  
Curtis Cooper
Keyword(s):  
Risk Factors ◽  
Hepatitis C ◽  
Treatment Outcomes ◽  
Social Deprivation ◽  
Administrative Databases ◽  
Hcv Treatment ◽  
Ottawa Hospital ◽  
Lifestyle Risk Factors ◽  
Infection Risk Factors ◽  
Lifestyle Risk

Background.Aboriginal Canadians face many lifestyle risk factors for hepatitis C exposure.Methods.An analysis of Ottawa Hospital Viral Hepatitis Clinic (Ottawa, Canada) patients between January 2000 and August 2013 was performed. HCV infection risk factors and HCV treatment outcomes were assessed. Socioeconomic status markers were based on area-level indicators linked to postal codes using administrative databases.Results.55 (2.8%) Aboriginal and 1923 (97.2%) non-Aboriginal patients were evaluated. Aboriginals were younger (45.6 versus 49.6 years,p<0.01). The distribution of gender (63.6% versus 68.3% male), HIV coinfection (9.1% versus 8.1%), advanced fibrosis stage (29.2% versus 28.0%), and SVR (56.3% versus 58.9%) was similar between groups. Aboriginals had a higher number of HCV risk factors, (mean 4.2 versus 3.1,p<0.001) with an odds ratio of 2.5 (95% confidence interval: 1.4–4.4) for having 4+ risk factors. This was not explained after adjustment for income, social deprivation, and poor housing. Aboriginal status was not related to SVR. Aboriginals interrupted therapy more often due to loss to follow-up, poor adherence, and substance abuse (25.0% versus 4.6%).Conclusion. Aboriginal Canadians have higher levels of HCV risk factors, even when adjusting for socioeconomic markers. Despite facing greater barriers to care, SVR rates were comparable with non-Aboriginals.

scholarly journals 199 Hepatitis C virus infection and risk factors in health-care workers at Ain Shams University Hospitals, Cairo, Egypt

2015 ◽  
Vol 21 (3) ◽  
pp. 199-212 ◽  
Author(s):  
O. Okasha ◽  
A. Munier ◽  
E, Delarocque-Astagneau ◽  
M. El Houssinie ◽  
M. Rafik ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Virus Infection ◽  
Health Care Workers ◽  
Hepatitis C Virus Infection ◽  
University Hospitals ◽  
Care Workers

scholarly journals Expanding Virtual Health Capabilities Into Trainee Health

2021 ◽  
Author(s):  
Elizabeth A Poindexter ◽  
Amanda Rodriguez ◽  
Timothy Switaj
Keyword(s):  
Health Care ◽  
Access To Care ◽  
San Antonio ◽  
Clinical Staff ◽  
Medical Clinic ◽  
Secure Messaging ◽  
Care Clinic ◽  
Instruction Time ◽  
Key Concepts ◽  
Improve Access

ABSTRACT Virtual health and secure messaging gained newfound relevance in medicine during the coronavirus disease (COVID)-19 pandemic. For a military trainee health care clinic located on Joint Base San Antonio, the McWethy Troop Medical Clinic (TMC), implementation of virtual health and secure messaging services meant decreased risk of COVID-19 exposure for trainees and clinical staff. Through ongoing utilization, these services also made impacts to reduce loss of instruction time and improve access to care for the McWethy TMC trainee population. In defining the challenges, successes, and future implications for virtual health and secure messaging at the McWethy TMC, key lessons emerge for other military trainee clinics. The key concepts explored in this article are virtual health and secure messaging.

Hepatitis C and Racial Disparity in Liver Transplant Waitlist Additions

2020 ◽  
Vol 86 (8) ◽  
pp. 985-990
Author(s):  
Chloe Q. Wang ◽  
Jacentha Buggs ◽  
Ebonie Rogers ◽  
Ashley Boyd ◽  
Ambuj Kumar ◽  
...  
Keyword(s):  
Health Care ◽  
Hepatitis C ◽  
Health Care Disparities ◽  
Organ Procurement ◽  
Ethnic Disparities ◽  
Racial Groups ◽  
Hcv Treatment ◽  
Treatment Disparities ◽  
Rate Of Decline ◽  
Direct Acting

Background In 2014, direct-acting antivirals (DAAs) became available for hepatitis C virus (HCV) with successful results. Since their implementation, the rate of HCV waitlist (WL) for liver transplantation (LT) has decreased, but significant ethnic disparities exist. We hypothesized that the rate of decline for HCV WL for LT is different across the various racial groups. Methods We conducted a retrospective cohort study using Organ Procurement and Transplantation Network data reports of adult LT candidates from 2014 to 2018. Results Overall, there was a decline in HCV WL rates for all ethnic groups (Caucasians, African Americans [AA], and Hispanics). However, the WL rates were significantly higher in AA compared with Caucasians each year, and this trend was continuous across the 5-year period. There were no differences in WL rates between Caucasians and Hispanics. Discussion The results show that health care disparities related to HCV disproportionately affect AA. The factors associated with this disparity need to be explored further to develop mechanisms to address these differences. By understanding the HCV treatment disparities across racial groups, modifications to HCV treatment nationwide can be adopted. Additional emphasis should be placed on AA to help reduce their WL rate, as well as redistributing resources to promote health care equity.

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