Early Successes in an Open Access, Provincially Funded Hepatitis C Treatment Program in Prince Edward Island
Introduction. The availability of curative hepatitis C therapies has created an opportunity to improve treatment delivery and access. Local providers, government, industry, and community groups in Prince Edward Island developed an innovative province-wide care model. Our goal was to describe the fir...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-03-01
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| Series: | Annals of Hepatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268119301541 |
| _version_ | 1819014326494691328 |
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| author | Jordan W. Francheville Robin Rankin Jeremy Beck Connie Hoare Stefanie Materniak Greg German Lisa Barrett Natalie Bunimov-Wall Daniel Smyth |
| author_facet | Jordan W. Francheville Robin Rankin Jeremy Beck Connie Hoare Stefanie Materniak Greg German Lisa Barrett Natalie Bunimov-Wall Daniel Smyth |
| author_sort | Jordan W. Francheville |
| collection | DOAJ |
| description | Introduction. The availability of curative hepatitis C therapies has created an opportunity to improve treatment delivery and access. Local providers, government, industry, and community groups in Prince Edward Island developed an innovative province-wide care model. Our goal was to describe the first year of program implementation.Material and methods. Using a communitybased prospective observational study design, all chronic hepatitis C referrals received from April 2015 to April 2016 were recorded in a database. Primary analysis assessed the time from referral to assessment/treatment, as well as the number of referrals, assessments, and treatment initiations. Secondary objectives included: (1) treatment effectiveness using intention-to-treat analysis; and (2) patient treatment experience assessed using demographics, adverse events, and medication adherence.Results. During the study period 242 referrals were received, 123 patients were seen for intake assessments, and 93 initiated direct-acting antiviral therapy based on medical need. This is compared to 4 treatment initiations in the previous 2 years. The median time from assessment to treatment initiation was 3 weeks. Eighty-two of 84 (97.6%, 95% CI 91.7 - 99.7%) patients for whom outcome data were available achieved sustained virologic response at 12 weeks post-treatment; 1 was lost to follow-up and 1 died from an unrelated event. In the voluntary registry, 39.7% of patients reported missed treatment doses.Conclusion. In conclusion, results from the first 12 months of this multi-phase hepatitis C elimination strategy demonstrate improved access to treatment, and high rates of safe engagement and cure for patients living with chronic hepatitis C genotype 1 infections. |
| first_indexed | 2024-12-21T02:14:04Z |
| format | Article |
| id | doaj.art-4887e1aeea444f20af84370a529945ca |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-12-21T02:14:04Z |
| publishDate | 2018-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-4887e1aeea444f20af84370a529945ca2022-12-21T19:19:18ZengElsevierAnnals of Hepatology1665-26812018-03-01172223231Early Successes in an Open Access, Provincially Funded Hepatitis C Treatment Program in Prince Edward IslandJordan W. Francheville0Robin Rankin1Jeremy Beck2Connie Hoare3Stefanie Materniak4Greg German5Lisa Barrett6Natalie Bunimov-Wall7Daniel Smyth8Dalhousie University, Nova Scotia, CanadaHealth PEI, Prince Edward Island, CanadaHealth PEI, Prince Edward Island, CanadaHealth PEI, Prince Edward Island, CanadaHorizon Health Network, New Brunswick, CanadaHealth PEI, Prince Edward Island, CanadaDalhousie University, Nova Scotia, Canada; Nova Scotia Health Authority, Nova Scotia, CanadaHorizon Health Network, New Brunswick, CanadaDalhousie University, Nova Scotia, Canada; Horizon Health Network, New Brunswick, Canada; Corresponding author.Introduction. The availability of curative hepatitis C therapies has created an opportunity to improve treatment delivery and access. Local providers, government, industry, and community groups in Prince Edward Island developed an innovative province-wide care model. Our goal was to describe the first year of program implementation.Material and methods. Using a communitybased prospective observational study design, all chronic hepatitis C referrals received from April 2015 to April 2016 were recorded in a database. Primary analysis assessed the time from referral to assessment/treatment, as well as the number of referrals, assessments, and treatment initiations. Secondary objectives included: (1) treatment effectiveness using intention-to-treat analysis; and (2) patient treatment experience assessed using demographics, adverse events, and medication adherence.Results. During the study period 242 referrals were received, 123 patients were seen for intake assessments, and 93 initiated direct-acting antiviral therapy based on medical need. This is compared to 4 treatment initiations in the previous 2 years. The median time from assessment to treatment initiation was 3 weeks. Eighty-two of 84 (97.6%, 95% CI 91.7 - 99.7%) patients for whom outcome data were available achieved sustained virologic response at 12 weeks post-treatment; 1 was lost to follow-up and 1 died from an unrelated event. In the voluntary registry, 39.7% of patients reported missed treatment doses.Conclusion. In conclusion, results from the first 12 months of this multi-phase hepatitis C elimination strategy demonstrate improved access to treatment, and high rates of safe engagement and cure for patients living with chronic hepatitis C genotype 1 infections.http://www.sciencedirect.com/science/article/pii/S1665268119301541Hepatitis C virusDirect-acting antiviralsReal-worldSustained virologic responseHealth plan implementation |
| spellingShingle | Jordan W. Francheville Robin Rankin Jeremy Beck Connie Hoare Stefanie Materniak Greg German Lisa Barrett Natalie Bunimov-Wall Daniel Smyth Early Successes in an Open Access, Provincially Funded Hepatitis C Treatment Program in Prince Edward Island Annals of Hepatology Hepatitis C virus Direct-acting antivirals Real-world Sustained virologic response Health plan implementation |
| title | Early Successes in an Open Access, Provincially Funded Hepatitis C Treatment Program in Prince Edward Island |
| title_full | Early Successes in an Open Access, Provincially Funded Hepatitis C Treatment Program in Prince Edward Island |
| title_fullStr | Early Successes in an Open Access, Provincially Funded Hepatitis C Treatment Program in Prince Edward Island |
| title_full_unstemmed | Early Successes in an Open Access, Provincially Funded Hepatitis C Treatment Program in Prince Edward Island |
| title_short | Early Successes in an Open Access, Provincially Funded Hepatitis C Treatment Program in Prince Edward Island |
| title_sort | early successes in an open access provincially funded hepatitis c treatment program in prince edward island |
| topic | Hepatitis C virus Direct-acting antivirals Real-world Sustained virologic response Health plan implementation |
| url | http://www.sciencedirect.com/science/article/pii/S1665268119301541 |
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