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Review
. 2018;10(4):431-446.
doi: 10.1007/s40506-018-0177-5. Epub 2018 Oct 18.

Building a Hepatitis C Clinical Program: Strategies to Optimize Outcomes

Autumn Zuckerman  1 , Alicia Carver  1 , Cody A Chastain  2
Affiliations
Review

Building a Hepatitis C Clinical Program: Strategies to Optimize Outcomes

Autumn Zuckerman et al. Curr Treat Options Infect Dis. 2018.

Abstract

Purpose of review: An increasing number of specialists and non-specialists are developing clinical programs to treat and cure hepatitis C virus (HCV). The goal of this paper is to evaluate and describe optimal strategies to improve outcomes related to HCV care delivery.

Recent findings: Screening and diagnosis of HCV should be guided by established recommendations. Given the recognized disparity in HCV diagnosis and linkage to care, a multi-modal approach involving care coordination and technology resources should be used to improve patient engagement. Access to HCV treatment may be optimized through systematic documentation, prior authorization, and appeal processes. Treatment monitoring should emphasize medication adherence, side effect and drug interaction management, as well as elimination of practical barriers. Finally, post-treatment engagement to promote liver health and reduce the risk of complications or reinfection maximizes the benefit of HCV treatment.

Summary: The landscape of HCV treatment has evolved from a specialist-driven model with few patients qualifying for treatment to an opportunity for non-specialists and other providers to provide curative therapies in most patients. Innovative practice models that employ a multidisciplinary approach will likely improve screening, diagnosis, engagement, and treatment outcomes.

Keywords: Care delivery; Cascade of care; HCV; Hepatitis C virus; Multidisciplinary care.

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Conflict of interest statement

Dr. Alicia Carver has no financial or ethical disclosures. Dr. Cody Chastain receives grant/research support from Gilead Sciences, Inc. Dr. Autumn Zuckerman receives grant/research support from Gilead Sciences, Inc.This article does not contain any studies with human or animal subjects performed by any of the authors.

Figures

Fig. 1
Fig. 1
Vanderbilt University Medical Center Division of Gastroenterology, Hepatology, and Nutrition and Division of Infectious Diseases employ a multidisciplinary approach in hepatitis C care delivery that integrates a prescribing provider (physician, nurse practitioner, or physician’s assistant), a pharmacist, and a pharmacy technician into clinical practice. The figure describes the cascade of care and corresponding responsibilities from an initial clinic visit through treatment completion and sustained virologic response.
See this image and copyright information in PMC

References

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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