BPharm, MSc Epidemiology, Epidemiology Lead, NPS MedicineWise, Sydney, NSW.
PhD, BBiomedSc(Hons), Medical Writer, NPS MedicineWise, Sydney, NSW.
Aust J Gen Pract. 2018 Sep;47(9):639-645. doi: 10.31128/AJGP-02-18-4482.
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.
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.
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.
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.
2016 年 3 月，直接作用抗病毒药物（DAAs）开始用于初级保健中的慢性丙型肝炎（CHC）患者，但并非所有患者都接受过治疗前评估。本研究旨在评估 CHC 患者在诊断和治疗连续体中的位置，以鼓励全科医生（GP）改善治疗前评估并提高 DAA 治疗的采用率。
这是一项使用一般实践数据程序 MedicineInsight 对 2013 年至 2017 年间首次记录的 4025 名成年 CHC 患者进行的横断面研究。
所有确诊 CHC 患者中，仅有一半患者记录了丙型肝炎病毒定性 RNA，且很少有患者接受了所有推荐的治疗前评估。大多数患者的天冬氨酸氨基转移酶血小板比值指数（APRI）评分较低。
治疗前评估不完整可能反映了 CHC 管理最近向初级保健的转移。大多数患者的 APRI 结果表明肝硬化的可能性不大，他们可能适合在初级保健中进行治疗。这突出了全科医生召回患者进行进一步评估和治疗的巨大机会。
