Insights into the management of chronic hepatitis C in primary care using MedicineInsight.

Aust J Gen Pract

MBBS, FRACP, PhD, Associate Professor of Medicine, St George and Sutherland Clinical School, UNSW; Head of Gastroenterology and Hepatology, St George Hospital, Sydney, NSW; Immediate past Chair, Australian Liver Association.

Published: September 2018

AI Article Synopsis

  • The study assesses the current state of diagnosis and care for patients with chronic hepatitis C (CHC) in primary care following the introduction of direct-acting antivirals (DAAs).
  • Only 50% of patients had necessary pre-treatment assessments completed, leading to a gap in treatment uptake.
  • The findings suggest that many patients may be eligible for treatment, indicating an opportunity for general practitioners (GPs) to improve patient follow-up and care.

Article Abstract

Background And Objectives: Direct-acting antivirals (DAAs) became available for patients with chronic hepatitis C (CHC) in primary care in March 2016, yet not all patients will have undergone pre-treatment assessment. The aim of this study was to assess where patients with CHC are situated in the diagnosis and care continuum, to encourage general practitioners (GPs) to improve pretreatment assessment and increase DAA treatment uptake.

Method: This was a cross-sectional study of 4025 adult patients with CHC first recorded between 2013 and 2017, using the general practice data program MedicineInsight.

Results: Only half of all patients with confirmed CHC had a hepatitis C virus qualitative RNA recorded, and few patients had all recommended pretreatment assessments. The majority had low aspartate aminotransferase to platelet ratio index (APRI) scores.

Discussion: Incomplete pretreatment assessment is likely to be a reflection of the recent shift in management of CHC to primary care. The majority of patients have APRI results that suggest cirrhosis is unlikely, and they are potentially suitable for treatment in primary care. This highlights a substantial opportunity for GPs to recall patients for further assessment and treatment.

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Source
http://dx.doi.org/10.31128/AJGP-02-18-4482DOI Listing

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