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爱尔兰肝脏护理服务创新项目。

HepCare Ireland-a service innovation project.

机构信息

Mater Misericordiae University Hospital, Dublin 7, Ireland.

University College Dublin, Dublin, Ireland.

出版信息

Ir J Med Sci. 2021 May;190(2):587-595. doi: 10.1007/s11845-020-02324-1. Epub 2020 Aug 6.

DOI:10.1007/s11845-020-02324-1
PMID:32761548
Abstract

Hepatitis C virus (HCV) remains a major cause of morbidity and death worldwide, with prevalence highest among people who inject drugs (PWID), homeless populations and prisoners. The World Health Organization has published targets to be achieved by 2030 as part of its global health sector strategy to eliminate viral hepatitis. Recent innovations in testing and treatment of HCV mean such goals are achievable with effective infrastructure, political will and funding. 'HepCare Europe' was a 3-year, EU-funded project involving four member states. It sought to develop, implement and evaluate interventions to improve HCV outcomes through multiple-level interventions, running between 2016 and 2019. This paper aims to summarize the methods and present the aggregate cascade of care figures for the Irish components of HepCare. 'HepCare Ireland' contained five integrated work packages: HepCheck, HepLink, HepFriend, HepEd and HepCost. Interventions included intensified screening, community-based assessment, linkage to specialist care, peer training and support, multidisciplinary educational resources and cost-effectiveness analysis. A total of 812 participants were recruited across the three clinical work packages in Ireland. Two hundred and fifty-seven (31.7%) of the tested participants had an HCV antibody-positive result, with 162 (63.0%) testing positive for HCV RNA. At the time of writing (6th of November 2019), 57 (54.8%) of participants put on treatment had achieved SVR12, with 44 (42.3%) still undergoing treatment. In HepCheck, HepLink. HepEd and HepFriend, we demonstrate a series of interventions to improve Irish HCV outcomes. Our findings highlight the benefits of multilevel interventions in HCV care.

摘要

丙型肝炎病毒(HCV)仍然是全球发病率和死亡率的主要原因,在注射毒品者(PWID)、无家可归者和囚犯中患病率最高。世界卫生组织发布了到 2030 年要实现的目标,作为其消除病毒性肝炎全球卫生部门战略的一部分。最近在 HCV 检测和治疗方面的创新意味着,如果有有效的基础设施、政治意愿和资金,这些目标是可以实现的。“HepCare Europe”是一个为期 3 年、由欧盟资助的项目,涉及四个成员国。它旨在通过多层次干预措施来开发、实施和评估干预措施,以改善 HCV 结果,这些干预措施在 2016 年至 2019 年期间实施。本文旨在总结方法并呈现 HepCare 爱尔兰部分的总体护理级联图。“HepCare Ireland”包含五个综合工作包:HepCheck、HepLink、HepFriend、HepEd 和 HepCost。干预措施包括强化筛查、基于社区的评估、与专科护理的联系、同伴培训和支持、多学科教育资源和成本效益分析。在爱尔兰的三个临床工作包中,共招募了 812 名参与者。在接受测试的 812 名参与者中,有 257 名(31.7%)的 HCV 抗体检测结果呈阳性,其中 162 名(63.0%)的 HCV RNA 检测结果呈阳性。在撰写本文时(2019 年 11 月 6 日),57 名(54.8%)接受治疗的参与者已达到 SVR12,其中 44 名(42.3%)仍在接受治疗。在 HepCheck、HepLink、HepEd 和 HepFriend 中,我们展示了一系列旨在改善爱尔兰 HCV 结果的干预措施。我们的研究结果突出了 HCV 护理中多层次干预措施的好处。

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本文引用的文献

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HepCare Europe-A service innovation project. HepCheck: Characteristics of the patient population with active infection as defined by HCV RNA.HepCare Europe-服务创新项目。HepCheck:通过 HCV RNA 定义的活跃感染患者人群的特征。
Int J Infect Dis. 2020 Feb;91:246-251. doi: 10.1016/j.ijid.2019.11.027. Epub 2019 Nov 27.
2
Integrating hepatitis C care for at-risk groups (HepLink): baseline data from a multicentre feasibility study in primary and community care.将丙型肝炎照护融入高风险族群(HepLink):基层与社区照护多中心可行性研究的基础数据。
J Antimicrob Chemother. 2019 Nov 1;74(Suppl 5):v31-v38. doi: 10.1093/jac/dkz454.
3
近期关于在健康和社会护理中使用同伴支持的有力证据的数量、多样性和性质是什么?一份证据与差距图。
Campbell Syst Rev. 2022 Jul 26;18(3):e1264. doi: 10.1002/cl2.1264. eCollection 2022 Sep.
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Pathogens. 2022 Nov 27;11(12):1428. doi: 10.3390/pathogens11121428.
HepCare Europe: a service innovation project. HepCheck: enhancing HCV identification and linkage to care for vulnerable populations through intensified outreach screening. A prospective multisite feasibility study.
HepCare 欧洲:一个服务创新项目。HepCheck:通过强化外展筛查,提高 HCV 识别和与弱势群体联系以获得护理的能力。一项前瞻性多地点可行性研究。
J Antimicrob Chemother. 2019 Nov 1;74(Suppl 5):v39-v46. doi: 10.1093/jac/dkz455.
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Evaluating the population impact of hepatitis C direct acting antiviral treatment as prevention for people who inject drugs (EPIToPe) - a natural experiment (protocol).评估丙型肝炎直接抗病毒治疗作为对注射毒品者的预防措施所产生的人群影响(EPIToPe)——一项自然实验(方案)
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