Primary care providers can treat hepatitis C.
Primary care providers such as non-specialist physicians and nurse practitioners can be quickly trained to provide direct-acting antiviral (DAA) therapy for hepatitis C with a high level of treatment success and provider satisfaction, according to a presentation at the 2016 AASLD Liver Meeting this month in Boston.
The advent of direct-acting antivirals used in interferon-free regimens has made treatment for chronic hepatitis C much more effective. In addition, DAA treatment is shorter — typically 8-12 weeks instead of 12-24 months — and simpler because it does not require interferon injections and management of its many side effects.
In addition to the cost of the new DAA drugs, another barrier to expanded access to treatment is that there are not enough liver disease specialists to treat everyone with hepatitis C. But specialized treatment may not be necessary for most patients with uncomplicated disease in the DAA era.
Sophy Wong and colleagues from the Alameda Health Consortium evaluated a simple, rapidly scalable model for building capacity among primary care providers (PCPs) to manage and treat people with hepatitis C in non-academic, non-specialist community health centers.
While primary care providers are often busy and even overburdened and suffering from “burnout,” Wong — herself a PCP — noted that they seldom have the opportunity to cure a serious disease themselves, and learning new skills to do so might improve job satisfaction.
In June 2015 a group of federally qualified health centers serving low-income urban populations in Alameda County, California (an area that includes Berkeley, Oakland, and Fremont) launched a training and mentorship program for primary care providers interested in treating hepatitis C.
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