Nurse practitioners as primary care site champions for the screening and treatment of hepatitis C virus.

Autor: Dale CH; Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada., Smith E; Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada.; Thames Valley Family Health Team, London, Ontario, Canada., Biondi MJ; Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada.; Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: Journal of the American Association of Nurse Practitioners [J Am Assoc Nurse Pract] 2022 Jan 21; Vol. 34 (4), pp. 688-695. Date of Electronic Publication: 2022 Jan 21.
DOI: 10.1097/JXX.0000000000000689
Abstrakt: Background: Primary care providers are often the first point of contact for hepatitis C virus (HCV) care, yet treatment initiation in primary care continues to be low. Nurse practitioners (NPs) are autonomous providers who, in Ontario, currently prescribe HCV therapy; however, methods to engage primary care NPs in HCV care have not occurred.
Purpose: To assess the feasibility of a systematic approach to train and support NPs in HCV testing, care, and treatment.
Methodology: Nurse practitioners from Canada's largest family health team (FHT) were recruited. Nurse practitioners received six hours of training and develop approaches to screen and treat at FHT sites. Treatment algorithms were given, and the number and types of inquiries from NPs were recorded.
Results: Over 1 year, 9 NPs screened 1,026 patients; 87.4% were screened based on the identification of a risk factor. A mail-out approach for birth cohort screening occurred at a single site, resulting in rapid uptake in screening. Antibody prevalence was 1.66%, with 76.5% RNA positivity. All RNA-positive treatment-eligible individuals were treated by an NP and completed treatment. Thirty-eight consults occurred over 1 year, the majority related to HCV or liver disease staging.
Conclusions: Formalized initiatives to engage and educate NPs lead to innovative strategies to test for HCV. Nurse practitioners can safely and effectively treat HCV in primary care with minimal support.
Implications: This work could be extrapolated to NPs in other primary care settings. Implementing formalized strategies has the potential to create NP leaders in the treatment and elimination of HCV in Ontario, Canada, and globally.
(Copyright © 2022 American Association of Nurse Practitioners.)
Databáze: MEDLINE