Department of Infectious Diseases, Odense University Hospital, Odense, Denmark.
Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
Infect Dis (Lond). 2023 May;55(5):361-369. doi: 10.1080/23744235.2023.2189298. Epub 2023 Mar 17.
The goal of the C-Free-South project is to eliminate hepatitis C (HCV) in the Region of Southern Denmark (1.2 million inhabitants). One target group consists of people with HCV who had received care but were lost to follow-up. The study aim was to evaluate program efficacy in locating these patients and getting them into care.
Patients were contacted if they were HCV-RNA positive and age 18+ years, registered in the clinical hepatitis database as of November 1, 2019, and had no scheduled HCV-related appointment. They were contacted at 2-month intervals by phone or letter. For patients who did not respond, we asked their general practitioner to refer them, if possible.
We identified 69 (7%) patients in the database who were listed as untreated and not being followed up. We successfully contacted 54 (78%), and the remaining 15 (22%) did not respond to our contacts. To date, 45 (65%) had initiated treatment, one (1%) had rejected treatment, and eight (12%) did not show up to their appointments. Among those receiving treatment, 20 (44%) responded after the first contact, 18 (40%) after the second contact, and 7 (16%) after informing the general practitioner.
An intensified and persistent effort made it possible to reach most HCV patients lost to follow-up. All new contact attempts increased the possibility that patients would receive treatment. Nevertheless, 22% of HCV patients lost to follow-up did not respond to repeated contact attempts.
C-Free-South 项目的目标是在丹麦南部地区(120 万居民)消除丙型肝炎(HCV)。目标人群之一是曾接受过治疗但失访的 HCV 患者。本研究旨在评估该项目找到这些患者并使他们接受治疗的效果。
如果患者 HCV-RNA 阳性且年龄≥18 岁,于 2019 年 11 月 1 日之前在临床肝炎数据库中登记且没有安排 HCV 相关预约,则对其进行联系。通过电话或信件每两个月联系一次患者。对于未回复的患者,如果可能,我们请他们的全科医生转介。
我们在数据库中发现了 69 名(7%)未经治疗且未被随访的患者。我们成功联系到了 54 名(78%)患者,其余 15 名(22%)未回复我们的联系。迄今为止,已有 45 名(65%)患者开始接受治疗,1 名(1%)拒绝治疗,8 名(12%)未按时就诊。在接受治疗的患者中,20 名(44%)在第一次联系后回复,18 名(40%)在第二次联系后回复,7 名(16%)在通知全科医生后回复。
经过强化和持续的努力,成功联系到了大多数失访的 HCV 患者。所有新的联系尝试都增加了患者接受治疗的可能性。然而,仍有 22%的失访 HCV 患者未对重复的联系尝试做出回应。