Journal Article

Evaluation of a person-centred, nurse-led model of care delivering hepatitis C testing and treatment in priority settings: a mixed-methods evaluation of the Tasmanian Eliminate Hepatitis C Australia Outreach Project, 2020–2022

Wilkinson, Anna L., Richmond, Jacqueline A., Hughes, Megan, Pedrana, Alisa, Dawe, Joshua, Walsh, Louisa, Doyle, Joseph S., Christensen, Shannon, Owen, Louise

2023

Overview

Introduction Australia has experienced sustained reductions in hepatitis C testing and treatment and may miss its 2030 elimination targets. Addressing gaps in community-based hepatitis C prescribing in priority settings that did not have, or did not prioritise, hepatitis C testing and treatment care pathways is critical. Methods The Tasmanian Eliminate Hepatitis C Australia Outreach Project delivered a nurse-led outreach model of care servicing hepatitis C priority populations in the community through the Tasmanian Statewide Sexual Health Service, supported by the Eliminating Hepatitis C Australia partnership. Settings included alcohol and other drug services, needle and syringe programs and mental health services. The project provided clients with clinical care across the hepatitis C cascade of care, including testing, treatment, and post-treatment support and hepatitis C education for staff. Results Between July 2020 and July 2022, a total of 43 sites were visited by one Clinical Nurse Consultant. There was a total of 695 interactions with clients across 219 days of service delivery by the Clinical Nurse Consultant. A total of 383 clients were tested for hepatitis C (antibody, RNA, or both). A total of 75 clients were diagnosed with hepatitis C RNA, of which 95% (71/75) commenced treatment, 83% (62/75) completed treatment and 52% (39/75) received a negative hepatitis C RNA test at least 12 weeks after treatment completion. Conclusions Providing outreach hepatitis C services in community-based services was effective in engaging people living with and at-risk of hepatitis C, in education, testing, and care. Nurse-led, person-centred care was critical to the success of the project. Our evaluation underscores the importance of employing a partnership approach when delivering hepatitis C models of care in community settings, and incorporating workforce education and capacity-building activities when working with non-specialist healthcare professionals.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Antibodies / Antiviral Agents - therapeutic use / Antiviral drugs / Australia / Biostatistics / Capacity development / Care and treatment / Clients / Diagnosis / Direct-acting antivirals / Education / Environmental Health / Epidemiology / Epidemiology of Viral Hepatitis / Evaluation / Harm reduction / Health services / Hepacivirus / Hepatitis / Hepatitis C / Hepatitis C - diagnosis / Hepatitis C - drug therapy / Hospitals / Humans / Medical personnel / Medical tests / Medicare / Medicine / Medicine & Public Health / Mental disorders / Mental health care / Nurse's Role / Nurse-led model of care / Partnerships / Patient-centered care / People who inject drugs / Pharmaceuticals / Prescription drugs / Primary care / Public Health / Ribonucleic acid / RNA / RNA - therapeutic use / Sexual health / Substance Abuse, Intravenous - psychology / Syringes / Vaccine