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Ann Hepatol. 2017 Sep-Oct;16(5):749-758. doi: 10.5604/01.3001.0010.2757.

Early Successes in an Open Access, Provincially Funded Hepatitis C Treatment Program in Prince Edward Island.

Author information

1
Dalhousie University, Nova Scotia, Canada.
2
Health PEI, Prince Edward Island, Canada.
3
Horizon Health Network, New Brunswick, Canada.

Abstract

INTRODUCTION:

The availability of curative hepatitis C therapies has created an opportunity to improve 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 community based 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.

KEYWORDS:

Direct-acting antivirals; Health plan implementation; Hepatitis C virus; Real-world; SVR

PMID:
28809740
DOI:
10.5604/01.3001.0010.2757
[Indexed for MEDLINE]
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