Outcomes of Treatment for Hepatitis C Virus Infection by Primary Care Providers.

[Guest guest]

N Engl J Med. 2011 Jun 1. [Epub ahead of print]

Outcomes of Treatment for Hepatitis C Virus Infection by Primary Care Providers.

Arora S, Thornton K, Murata G, Deming P, Kalishman S, Dion D, Parish B, Burke T,

Pak W, Dunkelberg J, Kistin M, Brown J, Jenkusky S, Komaromy M, Qualls C.

Source

From the Department of Internal Medicine (S.A., K.T., G.M., P.D., S.K., D.D.,

B.P., T.B., W.P., M. Kistin., J.B., M. Komaromy) and the Clinical and

Translational Science Center (C.Q.), University of New Mexico; and Presbyterian

Healthcare Services, Adult and Geriatric Behavioral Health Clinic (S.J.) - both

in Albuquerque; and the Department of Internal Medicine, University of Iowa,

Iowa City (J.D.).

Abstract

Background The Extension for Community Healthcare Outcomes (ECHO) model was

developed to improve access to care for underserved populations with complex

health problems such as hepatitis C virus (HCV) infection. With the use of

video-conferencing technology, the ECHO program trains primary care providers to

treat complex diseases. Methods We conducted a prospective cohort study

comparing treatment for HCV infection at the University of New Mexico (UNM) HCV

clinic with treatment by primary care clinicians at 21 ECHO sites in rural areas

and prisons in New Mexico. A total of 407 patients with chronic HCV infection

who had received no previous treatment for the infection were enrolled. The

primary end point was a sustained virologic response. Results A total of 57.5%

of the patients treated at the UNM HCV clinic (84 of 146 patients) and 58.2% of

those treated at ECHO sites (152 of 261 patients) had a sustained viral response

(difference in rates between sites, 0.7 percentage points; 95% confidence

interval, -9.2 to 10.7; P=0.89). Among patients with HCV genotype 1 infection,

the rate of sustained viral response was 45.8% (38 of 83 patients) at the UNM

HCV clinic and 49.7% (73 of 147 patients) at ECHO sites (P=0.57). Serious

adverse events occurred in 13.7% of the patients at the UNM HCV clinic and in

6.9% of the patients at ECHO sites. Conclusions The results of this study show

that the ECHO model is an effective way to treat HCV infection in underserved

communities. Implementation of this model would allow other states and nations

to treat a greater number of patients infected with HCV than they are currently

able to treat. (Funded by the Agency for Healthcare Research and Quality and

others.).

PMID: 21631316 [PubMed - as supplied by publisher] Free Article

[Guest guest]

N Engl J Med. 2011 Jun 1. [Epub ahead of print]

Outcomes of Treatment for Hepatitis C Virus Infection by Primary Care Providers.

Arora S, Thornton K, Murata G, Deming P, Kalishman S, Dion D, Parish B, Burke T,

Pak W, Dunkelberg J, Kistin M, Brown J, Jenkusky S, Komaromy M, Qualls C.

Source

From the Department of Internal Medicine (S.A., K.T., G.M., P.D., S.K., D.D.,

B.P., T.B., W.P., M. Kistin., J.B., M. Komaromy) and the Clinical and

Translational Science Center (C.Q.), University of New Mexico; and Presbyterian

Healthcare Services, Adult and Geriatric Behavioral Health Clinic (S.J.) - both

in Albuquerque; and the Department of Internal Medicine, University of Iowa,

Iowa City (J.D.).

Abstract

Background The Extension for Community Healthcare Outcomes (ECHO) model was

developed to improve access to care for underserved populations with complex

health problems such as hepatitis C virus (HCV) infection. With the use of

video-conferencing technology, the ECHO program trains primary care providers to

treat complex diseases. Methods We conducted a prospective cohort study

comparing treatment for HCV infection at the University of New Mexico (UNM) HCV

clinic with treatment by primary care clinicians at 21 ECHO sites in rural areas

and prisons in New Mexico. A total of 407 patients with chronic HCV infection

who had received no previous treatment for the infection were enrolled. The

primary end point was a sustained virologic response. Results A total of 57.5%

of the patients treated at the UNM HCV clinic (84 of 146 patients) and 58.2% of

those treated at ECHO sites (152 of 261 patients) had a sustained viral response

(difference in rates between sites, 0.7 percentage points; 95% confidence

interval, -9.2 to 10.7; P=0.89). Among patients with HCV genotype 1 infection,

the rate of sustained viral response was 45.8% (38 of 83 patients) at the UNM

HCV clinic and 49.7% (73 of 147 patients) at ECHO sites (P=0.57). Serious

adverse events occurred in 13.7% of the patients at the UNM HCV clinic and in

6.9% of the patients at ECHO sites. Conclusions The results of this study show

that the ECHO model is an effective way to treat HCV infection in underserved

communities. Implementation of this model would allow other states and nations

to treat a greater number of patients infected with HCV than they are currently

able to treat. (Funded by the Agency for Healthcare Research and Quality and

others.).

PMID: 21631316 [PubMed - as supplied by publisher] Free Article