School of Medicine, University College Dublin, Dublin, Ireland.
Mater Misericordiae University Hospital, Dublin, Ireland.
BMC Infect Dis. 2021 Mar 5;21(1):239. doi: 10.1186/s12879-021-05928-9.
Hepatitis C Virus (HCV) is a leading cause for chronic liver diseases worldwide. The European Union and World Health Organization aspire to eliminate HCV by 2030. However, among at-risk populations, including, homeless people, prisoners and People Who Inject Drugs, access to diagnosis and treatment is challenging. Hepcare Europe is an integrated model of care developed to address this by assessing potential reasons for these restrictions and determining measures needed to improve HCV diagnosis, treatment and access to care within different communities.
HepCare Europe is an EU-supported project involving collaboration between five institutions in: Ireland, United Kingdom, Spain and Romania. We aim to explore the journey of care experienced by those living with HCV with a focus on previous care disruptions (loss to follow up) and the new HepCare Europe Programme.
Research teams conducted semi-structured interviews with patients who accessed services through HepCare Europe thus, patients were recruited by purposeful sampling. Patients interviewed had received, or were in the final weeks of receiving, treatment. The interviews were audio recorded, transcribed and translated into English, and sent to the Dublin team for inductive thematic analysis. Researchers from the HepCare Europe research team coded the data separately, then together.
Common themes are introduced to present similarities, following individual site themes to highlight the importance of tailored interventions for each country. Key themes are: 1) Hepatitis C patients lost to follow up 2) HepCare improved access to treatment and 3) the need for improved HCV education. Individual themes also emerged for each site. These are: Ireland: New opportunities associated with achieving Sustained Virologic Responses (SVR). Romania: HCV is comparatively less crucial in light of Human Immunodeficiency Viruses (HIV) coinfections. UK: Patients desire support to overcome social barriers and Spain: Improved awareness of HCV, treatment and alcohol use.
This study identified how the tailored HepCare interventions enabled improved HCV testing and linkage to care outcomes for these patients. Tailored interventions that targeted the needs of patients, increased the acceptability and success of treatment by patients. HepCare demonstrated the need for flexibility in treatment delivery, and provided additional supports to keep patients engaged and educated on new treatment therapies.
丙型肝炎病毒（HCV）是全球慢性肝病的主要原因。欧盟和世界卫生组织渴望在 2030 年之前消除 HCV。然而，在包括无家可归者、囚犯和注射毒品者在内的高危人群中，获得诊断和治疗的机会具有挑战性。Hepcare Europe 是一种综合护理模式，旨在通过评估这些限制的潜在原因，并确定在不同社区中改善 HCV 诊断、治疗和获得护理所需的措施来解决这一问题。
HepCare Europe 是一个由欧盟支持的项目，涉及爱尔兰、英国、西班牙和罗马尼亚的五个机构之间的合作。我们的目标是探索 HCV 感染者的护理之旅，重点关注之前的护理中断（失访）和新的 HepCare Europe 计划。
研究团队对通过 HepCare Europe 获得服务的患者进行了半结构化访谈，因此通过有目的的抽样招募患者。接受采访的患者已经接受了治疗，或者正在接受治疗的最后几周。采访内容被录制下来，翻译成英文，并发送给都柏林团队进行归纳主题分析。来自 HepCare Europe 研究团队的研究人员分别对数据进行编码，然后再一起对数据进行编码。
引入共同主题是为了展示相似之处，然后再介绍每个国家的个性化主题，以突出为每个国家量身定制干预措施的重要性。关键主题是：1）丙型肝炎患者失访；2）HepCare 改善了治疗机会；3）需要加强 HCV 教育。每个地点也出现了个别主题。这些主题是：爱尔兰：实现持续病毒学应答（SVR）带来的新机会。罗马尼亚：与人类免疫缺陷病毒（HIV）合并感染相比，HCV 相对不那么重要。英国：患者希望克服社会障碍得到支持；西班牙：提高对 HCV、治疗和饮酒的认识。
本研究确定了定制的 HepCare 干预措施如何为这些患者改善 HCV 检测和与护理结果的联系。针对患者需求的定制干预措施提高了患者对治疗的接受程度和成功率。HepCare 表明需要灵活的治疗交付方式，并为保持患者参与和接受新的治疗疗法提供额外的支持。
