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将丙型肝炎治疗项目纳入基层医疗住院医师诊所

Implementation of a Hepatitis C Treatment Program Into a Primary Care Residency Clinic.

作者信息

Rhodes Morgan Adams, Humphrey Mark

机构信息

University of South Carolina School of Medicine, Department of Family and Preventive Medicine.

出版信息

PRiMER. 2021 Jan 22;5:1. doi: 10.22454/PRiMER.2021.532368. eCollection 2021.

Abstract

BACKGROUND AND OBJECTIVES

Hepatitis C (HCV) is a commonly diagnosed disease state in primary care. Regimen simplification has made eradication possible with improvements in treatment and improved access through primary care physician (PCP) education. Little has been published discussing the role of resident physicians in the treatment of HCV. We implemented an HCV treatment program to increase access to HCV care, identify effective training methods, and examine the efficacy of resident physician treatment. Objectives were to increase the number of patients treated, improve resident confidence in ability to treat HCV, and increase the likelihood that they will continue to treat patients after graduation.

METHODS

A curriculum to train physicians to treat HCV was developed and implemented in a large family medicine residency program. This was a single-center implementation, with a retrospective chart review of patient data and anonymous survey of clinicians for curriculum assessment. We analyzed data using descriptive statistics.

RESULTS

The resident physician survey had a 92.3% response rate (n=36). Precurriculum, 94.4% of residents were not confident in their ability to treat HCV. After program implementation, 25% of residents were confident in treating HCV. The most effective educational interventions involved the multidisciplinary team. To date, 30 patients have started treatment since 2017. Of the patients who completed treatment, 23 patients achieved a virologic cure.

CONCLUSION

Treating patients for HCV at a residency clinic increased physician confidence in evaluating and addressing this chronic disease and resulted in a cure of all patients treated.

摘要

背景与目的

丙型肝炎(HCV)是基层医疗中常见的诊断疾病状态。治疗方案的简化使根除丙型肝炎成为可能,这得益于治疗方法的改进以及通过对初级保健医生(PCP)的教育提高了可及性。关于住院医师在丙型肝炎治疗中的作用,鲜有文献发表。我们实施了一项丙型肝炎治疗项目,以增加丙型肝炎治疗的可及性,确定有效的培训方法,并检验住院医师治疗的疗效。目标是增加接受治疗的患者数量,提高住院医师治疗丙型肝炎的信心,并增加他们毕业后继续治疗患者的可能性。

方法

在一个大型家庭医学住院医师培训项目中开发并实施了一个培训医生治疗丙型肝炎的课程。这是一项单中心实施项目,对患者数据进行回顾性图表审查,并对临床医生进行匿名调查以评估课程。我们使用描述性统计分析数据。

结果

住院医师调查的回复率为92.3%(n = 36)。课程前,94.4%的住院医师对自己治疗丙型肝炎的能力没有信心。项目实施后,25%的住院医师对治疗丙型肝炎有信心。最有效的教育干预措施涉及多学科团队。截至目前,自2017年以来已有30名患者开始治疗。在完成治疗的患者中,23名患者实现了病毒学治愈。

结论

在住院医师诊所治疗丙型肝炎患者提高了医生评估和处理这种慢性病的信心,并使所有接受治疗的患者都得到了治愈。

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本文引用的文献

1
Hepatitis C Update and Expanding the Role of Primary Care.丙型肝炎最新情况及扩大初级保健的作用
J Am Board Fam Med. 2019 May-Jun;32(3):428-430. doi: 10.3122/jabfm.2019.03.180286.

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