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Happell B, Jacob A, Furness T, Stimson A, Curtis J, Watkins A, Platania-Phung C, Scholz B, Stanton R. Nurse-led physical health interventions for people with mental illness: an integrative review of international literature. J Ment Health 2024:1-23. [PMID: 39150334 DOI: 10.1080/09638237.2024.2390364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 04/29/2024] [Accepted: 06/06/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND People experiencing mental illness receive physical healthcare from nurses in a variety of settings including acute inpatient, secure extended care, forensic, and community services. While nurse-led clinical practice addressing sub-optimal consumer physical health is salient, a detailed understanding and description of the contribution by nurses to physical health interventions in people experiencing mental illness is not clearly articulated in the literature. AIMS The aim of this integrative review is to describe the state of knowledge on nurse-led physical health intervention for consumers, focusing on nursing roles, nursing assessment, and intervention settings. METHODS A systematic search of six databases using Medical Subject Headings from 2001 and 2022 inclusive was conducted. The Mixed Methods Appraisal Tool (MMAT) was utilised for quality appraisal. RESULTS Seventy-four studies were identified as "nurse-led". Interventions were most common among community settings (n = 34, 46%). Nurses performed varied roles, often concurrently, including the collection of 341 physical health outcomes, and multiple roles with 225 distinct nursing actions identified across the included studies. A nurse as lead author was common among the included studies (n = 46, 62%). However, nurses were not always recognised for their efforts or contributions in authorship. CONCLUSIONS There is potential gap in role recognition that should be considered when designing and reporting nurse-led physical health interventions.
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Affiliation(s)
- Brenda Happell
- Faculty of Health, Southern Cross University, Adelaide, New South Wales, Australia
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Alycia Jacob
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Trentham Furness
- Faculty of Health, Southern Cross University, Adelaide, New South Wales, Australia
- Forensicare, Fairfield, Victoria, Australia
| | - Alisa Stimson
- School of Nursing, Midwifery and Social Sciences, CQUniversity, Rockhampton, Queensland, Australia
| | - Jackie Curtis
- Mindgardens Neuroscience Network, South East Sydney Local Health District, Sydney, New South Wales, Australia
| | - Andrew Watkins
- Mindgardens Neuroscience Network, South East Sydney Local Health District, Sydney, New South Wales, Australia
| | - Chris Platania-Phung
- Department of Psychology, Australian College of Applied Psychology, Melbourne, Australia
| | - Brett Scholz
- Medical School, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Robert Stanton
- Cluster for Resilience and Wellbeing, Appleton Institute, South Australia, Australia
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Queensland, Australia
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Searby A, Burr D, Blums C, Harrison J, Smyth D. Exploring a pilot alcohol and other drug (AOD) nurse practitioner mentoring program: Empirical research mixed methods: A pilot nurse practitioner mentoring program. Nurs Open 2024; 11:e2250. [PMID: 39126170 PMCID: PMC11315737 DOI: 10.1002/nop2.2250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/09/2024] [Accepted: 07/31/2024] [Indexed: 08/12/2024] Open
Abstract
AIM To explore the effectiveness and acceptability of a pilot mentoring program for alcohol and other drug (AOD) nurse practitioners (also known globally as addiction nurse practitioners). DESIGN Mixed method evaluation. METHODS Two-phase evaluation comprising survey (demographics, pre- and post-program perceived competency and confidence) with 15 participants completing the pre survey and 10 participants completing the post survey, and qualitative interviews after the program with 10 participants. RESULTS The quantitative results indicate statistically significant increases in some domains of perceived competence and confidence in treatment. Qualitative findings indicate that participants valued peer support and mentoring from experienced nurse practitioners. Where formal residency or internship programs for nurse practitioners do not exist, informal mentoring programs may address issues inherent in nurse practitioner transition that may impact retention. We recommend further exploration of mentoring programs with larger sample sizes to determine if self-reported clinical improvements are noted. IMPLICATIONS FOR PROFESSION AND/OR PATIENT CARE Nurse practitioners are a vital part of the healthcare system; their advanced skills and knowledge place them in an ideal position to address prescriber shortages and access to care for populations underserved by healthcare. However, literature indicates that they are often underutilised, and transition to autonomous practice remains a challenge. Our exploration of a pilot mentoring program for nurse practitioners shows that their knowledge and perceived skills are high, yet peer assistance is valued in transitioning from advanced practice registered nurse to autonomous nurse practitioner. We recommend further trialling and evaluation of nurse practitioner mentoring programs to both increase supply of nurse practitioners and provide greater access to quality healthcare for underserved populations. IMPACT What problem did the study address? The ability of nurse practitioners to offer advanced practice interventions such as diagnosis and medication management potentially provides a solution to healthcare resource shortages. However, current literature indicates that advanced nurses transitioning to nurse practitioner roles suffer transition shock, leading to burnout and poor retention. What were the main findings? Although this pilot mentoring program shows significant improvements in survey responses on confidence and capability, qualitative data shows that neophyte nurse practitioners value peer support and mentoring from more experienced practitioners. Participants described maintaining ongoing connections with both mentors and fellow mentees, which aided transition to the role of autonomous nurse practitioner. Where and on whom will the research have an impact? The results of this pilot mentoring program indicate that there is benefit to these programs for neophyte nurse practitioners in many specialties. This paper indicates that mentoring programs for nurse practitioners may provide a community of practice and may have a positive impact on transition shock. REPORTING METHOD Good Reporting of a Mixed Methods Study (GRAMMS) checklist. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Adam Searby
- Monash University School of Nursing and MidwiferyClaytonVictoriaAustralia
- Drug and Alcohol Nurses of Australasia (DANA)BrisbaneQueenslandAustralia
| | - Dianna Burr
- Monash University School of Nursing and MidwiferyClaytonVictoriaAustralia
| | - Colleen Blums
- Drug and Alcohol Nurses of Australasia (DANA)BrisbaneQueenslandAustralia
| | - Jason Harrison
- Drug and Alcohol Nurses of Australasia (DANA)BrisbaneQueenslandAustralia
- Central Queensland Mental HealthAlcohol and Other Drug ServiceRockhamptonQueenslandAustralia
| | - Darren Smyth
- Drug and Alcohol Nurses of Australasia (DANA)BrisbaneQueenslandAustralia
- Queensland Injectors Health Network (QuIHN)Gold CoastQueenslandAustralia
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Gofton C, Bondezi K, Kotze B, McKee K, Yesudoss A, McCaughan G, George J. Micro-elimination of chronic hepatitis C virus in mental health settings: A prospective multicentre pragmatic trial. Drug Alcohol Rev 2024; 43:1247-1255. [PMID: 38773898 DOI: 10.1111/dar.13854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 03/24/2024] [Accepted: 03/27/2024] [Indexed: 05/24/2024]
Abstract
INTRODUCTION Hepatitis C virus (HCV) prevalence is high in the mental health population. We sought to evaluate testing and treatment uptake for HCV following the implementation of a universal nurse led study in inpatient and outpatient mental health populations. METHODS From January 2018 to December 2020, we screened mental health inpatients (n = 322) and community mental health patients (n = 615) for HCV with either specialist hepatology nurses or mental health nurses (mental health nurse). RESULTS 75.5% (464/615) of community patients and 100% (322/322) of inpatients consented to screening, with an HCV antibody-positive prevalence of 12.7% (59/464) in community patients and 19.6% (63/322) in inpatients. RNA detectable prevalence was 4.0% (22/464) and 7.5% (24/322), respectively. Community patients who were screened by specialist hepatology nurses were more likely to consent to screening (94.4% vs. 45.7%, p < 0.001) but had lower proportion of HCV antibody (10.5% vs. 20.3%, p < 0.001) and RNA detectable (4.0% vs. 7.5%, p = 0.018) when compared to mental health nurse screening. Engagement with treatment was 27.0% of community mental health patients and 45.8% of mental health inpatients undergoing treatment. All patients undergoing treatment and underwent sustained viral response (SVR) testing achieved SVR. DISCUSSION AND CONCLUSIONS Universal screening of HCV using a nurse-led model has high rates of success in mental health patients with high proportions undergoing screening, with no reduction in the rates of SVR achieved with DAA therapy compared to the general population. Further work is needed to bridge the gap between identification of HCV and treatment among mental health patients.
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Affiliation(s)
- Cameron Gofton
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and The University of Sydney, Sydney, New South Wales, Australia
- Department of Gastroenterology and Hepatology, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Department of Gastroenterology and Hepatology, Bankstown-Lidcombe Hospital, Sydney, New South Wales, Australia
| | - Kindness Bondezi
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and The University of Sydney, Sydney, New South Wales, Australia
| | - Beth Kotze
- Sydney Local Health District, Sydney, New South Wales, Australia
| | - Kristen McKee
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and The University of Sydney, Sydney, New South Wales, Australia
| | - Antoni Yesudoss
- Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Geoff McCaughan
- AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney Local Health District, Centenary Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Jacob George
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and The University of Sydney, Sydney, New South Wales, Australia
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Roder C, Cosgrave C, Mackie K, McNamara B, Doyle JS, Wade AJ. Missed Opportunities: A Retrospective Study of Hepatitis C Testing in Hospital Inpatients. Viruses 2024; 16:979. [PMID: 38932269 PMCID: PMC11209528 DOI: 10.3390/v16060979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/08/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
Increasing testing is key to achieving hepatitis C elimination. This retrospective study aimed to assess the testing cascade of patients at a regional hospital in Victoria, Australia, who inject drugs or are living with hepatitis C, to identify missed opportunities for hepatitis C care. Adult hospital inpatients and emergency department (ED) attendees from 2018 to 2021 with indications for intravenous drug use (IDU) or hepatitis C on their discharge or ED summary were included. Data sources: hospital admissions, pathology, hospital pharmacy, and outpatients. We assessed progression through the testing cascade and performed logistic regression analysis for predictors of hepatitis C care, including testing and treatment. Of 79,923 adults admitted, 1345 (1.7%) had IDU-coded separations and 628 (0.8%) had hepatitis C-coded separations (N = 1892). Hepatitis C virus (HCV) status at the end of the study was unknown for 1569 (82.9%). ED admissions were associated with increased odds of not providing hepatitis C care (odds ratio 3.29, 95% confidence interval 2.42-4.48). More than 2% of inpatients at our hospital have an indication for testing, however, most are not being tested despite their hospital contact. As we work toward HCV elimination in our region, we need to incorporate testing and linkage strategies within hospital departments with a higher prevalence of people at risk of infection.
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Affiliation(s)
- Christine Roder
- Barwon South West Public Health Unit, Barwon Health, Geelong 3220, Australia;
- Centre for Innovation in Infectious Disease and Immunology Research (CIIDIR), Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong 3220, Australia
| | - Carl Cosgrave
- Gastroenterology Department, Barwon Health, Geelong 3220, Australia;
| | - Kathryn Mackie
- Pharmacy Department, Barwon Health, Geelong 3220, Australia;
- Pharmacy Department, Alfred Health, Melbourne 3004, Australia
| | - Bridgette McNamara
- Barwon South West Public Health Unit, Barwon Health, Geelong 3220, Australia;
- Centre for Innovation in Infectious Disease and Immunology Research (CIIDIR), Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong 3220, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia
| | - Joseph S. Doyle
- Disease Elimination Program, Burnet Institute, Melbourne 3004, Australia;
- Department of Infectious Disease, Alfred Health, Melbourne 3004, Australia
| | - Amanda J. Wade
- Barwon South West Public Health Unit, Barwon Health, Geelong 3220, Australia;
- Centre for Innovation in Infectious Disease and Immunology Research (CIIDIR), Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong 3220, Australia
- Disease Elimination Program, Burnet Institute, Melbourne 3004, Australia;
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Barré T, Bourlière M, Parlati L, Ramier C, Marcellin F, Protopopescu C, Di Beo V, Cagnot C, Dorival C, Nicol J, Zoulim F, Carrat F, Carrieri P. Hepatitis C virus cure from direct-acting antivirals and mortality: Are people with and without a history of injection drug use in the same boat? (ANRS CO22 Hepather cohort). Drug Alcohol Rev 2024; 43:718-731. [PMID: 38133601 DOI: 10.1111/dar.13802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION The risk of mortality in people with a history of injection drug use (PHID) is high, as is the prevalence of hepatitis C virus (HCV) infection. Although direct-acting antivirals (DAA) are effective in this population in terms of sustained virological response, it is not known whether PHID benefit as much as people with no history of injection drug use from DAA-related HCV cure in terms of reduced all-cause mortality. METHODS Using Cox proportional hazards models based on the ANRS CO22 Hepather cohort data (n = 9735), we identified factors associated with all-cause mortality among HCV-infected people. We tested for interaction effects between drug injection status, HCV cure and other explanatory variables. RESULTS DAA-related HCV cure was associated with a 66% (adjusted hazard ratio [95% confidence interval]: 0.34 [0.29-0.39]) lower risk of all-cause mortality, irrespective of drug injection status. Detrimental effects of unhealthy alcohol use on mortality were identified in PHID only. DISCUSSION AND CONCLUSIONS DAA-related HCV cure led to comparable benefits in terms of reduced mortality in PHID and people with no history of injection drug use. Policies and strategies to enhance DAA uptake among PHID are needed to lower mortality in this population. Clinical trial registration details: ClinicalTrials.gov: NCT01953458.
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Affiliation(s)
- Tangui Barré
- Aix Marseille Université, Institut National de la Santé et de la Recherche Médicale, Institut de Recherche pour le Developpement , Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Institut des Sciences de la Santé Publique d'Aix-Marseille, Marseille, France
| | - Marc Bourlière
- Aix Marseille Université, Institut National de la Santé et de la Recherche Médicale, Institut de Recherche pour le Developpement , Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Institut des Sciences de la Santé Publique d'Aix-Marseille, Marseille, France
- Département d'hépatologie et gastroentérologie, Hôpital Saint Joseph, Marseille, France
| | - Lucia Parlati
- Université de Paris Cité; Institut National de la Santé et de la Recherche Médicale; Assistance Publique-Hôpitaux de Paris, Département d'Hépatologie/Addictologie, Hôpital Cochin, Paris, France
| | - Clémence Ramier
- Aix Marseille Université, Institut National de la Santé et de la Recherche Médicale, Institut de Recherche pour le Developpement , Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Institut des Sciences de la Santé Publique d'Aix-Marseille, Marseille, France
| | - Fabienne Marcellin
- Aix Marseille Université, Institut National de la Santé et de la Recherche Médicale, Institut de Recherche pour le Developpement , Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Institut des Sciences de la Santé Publique d'Aix-Marseille, Marseille, France
| | - Camelia Protopopescu
- Aix Marseille Université, Institut National de la Santé et de la Recherche Médicale, Institut de Recherche pour le Developpement , Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Institut des Sciences de la Santé Publique d'Aix-Marseille, Marseille, France
| | - Vincent Di Beo
- Aix Marseille Université, Institut National de la Santé et de la Recherche Médicale, Institut de Recherche pour le Developpement , Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Institut des Sciences de la Santé Publique d'Aix-Marseille, Marseille, France
| | - Carole Cagnot
- ANRS | Emerging Infectious Diseases, Department of Clinical Research, Paris, France
| | - Celine Dorival
- Institut National de la Santé et de la Recherche Médicale, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Jérôme Nicol
- Institut National de la Santé et de la Recherche Médicale, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Fabien Zoulim
- Institut National de la Santé et de la Recherche Médicale U1052, Centre National de la Recherche Scientifique, Unités Mixtes de Recherche-5286, Cancer Research Center of Lyon, Lyon, France
- University of Lyon, Université Claude-Bernard, Lyon, France
- Hospices Civils de Lyon, Lyon, France
| | - Fabrice Carrat
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Hôpital Saint-Antoine, Unité de Santé Publique, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Patrizia Carrieri
- Aix Marseille Université, Institut National de la Santé et de la Recherche Médicale, Institut de Recherche pour le Developpement , Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Institut des Sciences de la Santé Publique d'Aix-Marseille, Marseille, France
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Clark PJ, Valery PC, Strasser SI, Weltman M, Thompson A, Levy MT, Leggett B, Zekry A, Rong J, Sinclair M, George J, Bollipo S, McGarity B, Sievert W, MacQuillan G, Tse E, Nicoll A, Wade A, Cheng W, Roberts SK. Broadening and strengthening the health providers caring for patients with chronic hepatitis C may improve continuity of care. J Gastroenterol Hepatol 2024; 39:568-575. [PMID: 38114452 DOI: 10.1111/jgh.16440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/14/2023] [Accepted: 11/19/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Direct-acting antiviral (DAA) therapies for hepatitis C virus infection (HCV) lead to excellent rates of sustained virological response (SVR). However, loss to follow-up (LTFU) for SVR testing remains a challenge. We examine factors associated with LTFU in a real-world setting. METHODS Adults who received DAA therapy for HCV in one of 26 centers across Australia during 2016-2021 were followed up for 2 years. Data sources included the patient medical records and the national Pharmaceutical and Medicare Benefits Schemes. Linkage to Medicare provided utilization data of other health-care providers and re-treatment with DAAs. LTFU was defined as no clinic attendance for SVR testing by at least 52 weeks after DAA treatment commencement. Multivariable logistic regression assessed factors associated with LTFU. RESULTS In 3619 patients included in the study (mean age 52.0 years; SD = 10.5), 33.6% had cirrhosis (69.4% Child-Pugh class B/C), and 19.3% had HCV treatment prior to the DAA era. Five hundred and fifteen patients (14.2%) were LTFU. HCV treatment initiation in 2017 or later (adj-OR = 2.82, 95% confidence interval [CI] 2.25-3.54), younger age (adj-OR = 2.63, 95% CI 1.80-3.84), Indigenous identification (adj-OR = 1.99, 95% CI 1.23-3.21), current injection drug use or opioid replacement therapy (adj-OR = 1.66, 95% CI 1.25-2.20), depression treatment (adj-OR = 1.49, 95% CI 1.17-1.90), and male gender (adj-OR = 1.31, 95% CI 1.04-1.66) were associated with LTFU. CONCLUSIONS These findings stress the importance of strengthening the network of providers caring for patients with HCV. In particular, services targeting vulnerable groups of patients such as First Nations Peoples, youth health, and those with addiction and mental health disorders should be equipped to treat HCV.
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Affiliation(s)
- Paul J Clark
- Department of Gastroenterology, Princess Alexandra and Mater Hospitals, and Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Patricia C Valery
- QIMR Berghofer Medical Research Institute, and Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Simone I Strasser
- AW Morrow Gastroenterology and Liver Centre Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Martin Weltman
- Hepatology Services, Nepean Hospital, Penrith, New South Wales, Australia
| | - Alex Thompson
- Department of Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Miriam T Levy
- USYD, Department of Gastroenterology and Liver, Liverpool Hospital, Sydney, New South Wales, Australia
| | - Barbara Leggett
- Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital and Faculty of Medicine, Brisbane, Queensland, Australia
| | - Amany Zekry
- Department of Gastroenterology and Hepatology, St George Hospital, Sydney, New South Wales, Australia
| | - Julian Rong
- Gippsland Gastroenterology, Latrobe Regional Hospital, Traralgon, Victoria, 3844, Australia
| | - Marie Sinclair
- Department of Gastroenterology and Hepatology, Austin Hospital, Melbourne, Victoria, Australia
| | - Jacob George
- Faculty of Medicine, The University of Sydney, Sydney, New South Wales, Australia
- Storr Liver Unit, Westmead Hospital, Westmead, New South Wales, Australia
| | - Steven Bollipo
- Gastroenterology Department, John Hunter Hospital, New Lambton, New South Wales, Australia
- Gastroenterology Department, John Hunter Hospital, Newcastle and School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Bruce McGarity
- Bathurst Liver Clinic Bathurst Hospital, Bathurst, New South Wales, Australia
| | - William Sievert
- Gastrointestinal and Liver Unit, Monash Health and Monash University, Melbourne, Victoria, Australia
| | - Gerry MacQuillan
- Department of Hepatology and Liver Transplant Unit, Sir Charles Gairdner Hospital, Nedlands, West Australia, Australia
| | - Edmund Tse
- Hepatology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | | | - Amanda Wade
- Burnet Institute, Melbourne, Victoria, Australia
- Barwon Health Liver Clinic University Hospital, Geelong, Victoria, Australia
| | - Wendy Cheng
- Department of Gastroenterology and Hepatology, Royal Perth Hospital, Perth, West Australia, Australia
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Huang CF, Jang TY, Yu SC, Huang SC, Ho SL, Yeh ML, Wang CW, Liang PC, Wei YJ, Hsu PY, Huang CI, Hsieh MY, Lin YH, Yu SL, Wu PF, Chen YH, Chien SC, Huang JF, Dai CY, Chuang WL, Wang TJ, Yu ML. Patient-centered and integrated outreach care for chronic hepatitis C patients with serious mental illness in Taiwan. Kaohsiung J Med Sci 2024; 40:86-93. [PMID: 37942784 DOI: 10.1002/kjm2.12780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/10/2023] [Accepted: 09/27/2023] [Indexed: 11/10/2023] Open
Abstract
Patients with serious mental illness have a higher risk of hepatitis C virus (HCV) infection but suboptimal HCV care. The current study aimed to facilitate HCV treatment uptake by implementing an integrated outreach care model. Multidisciplinary outreach screening followed by HCV reflex testing and onsite treatment for schizophrenia patients was accomplished through the coordination of nongovernmental organizations, remote specialists, and local care providers. The objective was microelimination effectiveness, defined as the multiplication of the rates of anti-HCV antibodies screening, accurate HCV RNA diagnosis, treatment allocation, treatment completion, and sustained virological response (SVR12; no detectable HCV RNA throughout 12 weeks in the post-treatment follow-up period). A total of 1478 of the 2300 (64.3%) psychiatric patients received HCV mass screening. Seventy-three (4.9%) individuals were seropositive for anti-HCV antibodies. Of the 73 anti-HCV seropositive patients, all (100%) received HCV reflex testing, and 29 (37.7%) patients had HCV viremia. Eight patients (34.8%) had advanced liver disease, including 3 with liver cirrhosis and 2 with newly diagnosed hepatocellular carcinoma. Twenty-three of the 24 (95.8%) patients who stayed in the healthcare system received and completed 8 weeks of glecaprevir/pibrentasvir treatment and post-treatment follow-up without significant DDIs or adverse events. The SVR12 rate was 100%. The microelimination effectiveness in the current study was 61.6%. Individuals with serious mental illness are underserved and suffer from diagnostic delays. This patient-centered and integrated outreach program facilitated HCV care in this marginalized population.
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Affiliation(s)
- Chung-Feng Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Ph.D. Program in Translational Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Academia Sinica, Taipei, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tyng-Yuan Jang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shun-Chieh Yu
- Department of General Psychiatry, Yuli Hospital, Ministry of Health and Welfare, Hualien, Taiwan
| | - Shin-Chung Huang
- Pharmacy Department, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shao-Lun Ho
- Department of Otolaryngology, Yuli Hospital, Ministry of Health and Welfare, Hualien, Taiwan
| | - Ming-Lun Yeh
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Wen Wang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Taiwan
| | - Po-Cheng Liang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yu-Ju Wei
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Po-Yao Hsu
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ching-I Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Yen Hsieh
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Yi-Hung Lin
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Taiwan
| | - Sung-Lin Yu
- Department of Neurology, Yuli Hospital, Ministry of Health and Welfare, Hualien, Taiwan
| | - Pey-Fang Wu
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yu-Han Chen
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shin-Chi Chien
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jee-Fu Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Yen Dai
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wan-Long Chuang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tso-Jen Wang
- Department of General Psychiatry, Yuli Hospital, Ministry of Health and Welfare, Hualien, Taiwan
- Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Ming-Lung Yu
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- School of Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-sen University, Kaohsiung, Taiwan
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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8
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Dawe J, Hughes M, Christensen S, Walsh L, Richmond JA, Pedrana A, Wilkinson AL, Owen L, Doyle JS. 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. BMC Public Health 2023; 23:2289. [PMID: 37985979 PMCID: PMC10662700 DOI: 10.1186/s12889-023-17066-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/25/2023] [Indexed: 11/22/2023] Open
Abstract
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.
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Affiliation(s)
- Joshua Dawe
- Disease Elimination, Burnet Institute, Melbourne, Australia.
| | - Megan Hughes
- Sexual Health Service Tasmania, Hobart, Australia
| | | | - Louisa Walsh
- Disease Elimination, Burnet Institute, Melbourne, Australia
- Centre for Health Communication and Participation, La Trobe University, Melbourne, Australia
| | | | - Alisa Pedrana
- Disease Elimination, Burnet Institute, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Anna L Wilkinson
- Disease Elimination, Burnet Institute, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Louise Owen
- Sexual Health Service Tasmania, Hobart, Australia
| | - Joseph S Doyle
- Disease Elimination, Burnet Institute, Melbourne, Australia
- Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Australia
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9
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Gréaux M, Moro MF, Kamenov K, Russell AM, Barrett D, Cieza A. Health equity for persons with disabilities: a global scoping review on barriers and interventions in healthcare services. Int J Equity Health 2023; 22:236. [PMID: 37957602 PMCID: PMC10644565 DOI: 10.1186/s12939-023-02035-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/11/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Persons with disabilities experience health inequities in terms of increased mortality, morbidity, and limitations in functioning when compared to the rest of the population. Many of the poor health outcomes experienced by persons with disabilities cannot be explained by the underlying health condition or impairment, but are health inequities driven by unfair societal and health system factors. A synthesis of the global evidence is needed to identify the factors that hinder equitable access to healthcare services for persons with disabilities, and the interventions to remove these barriers and promote disability inclusion. METHODS We conducted a scoping review following the methodological framework proposed by Arksey and O'Malley, Int J Soc Res Methodol 8:19-32. We searched two scholarly databases, namely MEDLINE (Ovid) and Web of Science, the websites of Organizations of Persons with Disabilities and governments, and reviewed evidence shared during WHO-led consultations on the topic of health equity for persons with disabilities. We included articles published after 2011 with no restriction to geographical location, the type of underlying impairments or healthcare services. A charting form was developed and used to extract the relevant information for each included article. RESULTS Of 11,884 articles identified in the search, we included 182 articles in this review. The majority of sources originated from high-income countries. Barriers were identified worldwide across different levels of the health system (such as healthcare costs, untrained healthcare workforces, issues of inclusive and coordinated services delivery), and through wider contributing factors of health inequities that expand beyond the health system (such as societal stigma or health literacy). However, the interventions to promote equitable access to healthcare services for persons with disabilities were not readily mapped onto those needs, their sources of funding and projected sustainability were often unclear, and few offered targeted approaches to address issues faced by marginalized groups of persons with disabilities with intersectional identities. CONCLUSION Persons with disabilities continue to face considerable barriers when accessing healthcare services, which negatively affects their chances of achieving their highest attainable standard of health. It is encouraging to note the increasing evidence on interventions targeting equitable access to healthcare services, but they remain too few and sparce to meet the populations' needs. Profound systemic changes and action-oriented strategies are warranted to promote health equity for persons with disabilities, and advance global health priorities.
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Affiliation(s)
- Mélanie Gréaux
- Faculty of Education, University of Cambridge, Cambridge, UK.
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10
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Byrne CJ, Radley A, Fletcher E, Thain D, Stephens BP, Dillon JF. A multicomponent holistic care pathway for people who use drugs in Tayside, Scotland. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 120:104159. [PMID: 37574644 DOI: 10.1016/j.drugpo.2023.104159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND People Who Use Drugs (PWUD) are at high risk of non-fatal overdose and other drug-related harms. The United Kingdom drugs policy landscape makes it challenging to support those at risk. Tayside, in East Scotland, has a sizeable population at risk of drug-related harms. In 2021, the National Health Service implemented a care pathway for PWUD to provide multidimensional healthcare interventions. We aimed to quantify drug-related harms; assess wider health and well-being; and understand substance use trends and behaviours, among those engaged in the pathway. METHODS Existing community-embedded blood-borne virus pathways were adapted to provide multiple healthcare assessments over three visits. We undertook an observational cohort study to analyse uptake and outcomes for the initial cohort of PWUD engaged at appointment one. RESULTS From August 2021-September 2022, 150 PWUD engaged with the pathway. Median age was 39 (34-42) years, 108 (72%) were male, and 124 (83%) lived in deprived areas. Seventy (47%) had been disengaged from healthcare for over a year. Polysubstance use was reported by 124 (83%), 42 (28%) disclosed injecting daily, and 54 (36%) shared equipment. Fifty-four (36%) experienced recent non-fatal overdose, and there were six overdose fatalities (4.1 [1.5-9.0] per 100PY). The offer of take-home naloxone was accepted by 108 (72%). Fourteen (9%) were diagnosed with Hepatitis C and two (1%) with HIV. Renal, hepatological, and endocrine impairment were observed among 30 (20%), 23 (15%), and 11 (7%), people respectively. Ninety-six (65%) had high risk of clinical depression. Forty-eight (32%) declined Covid-19 vaccination. CONCLUSION The pathway engaged PWUD with high exposure to recent non-fatal overdose and other drug-related harms, alongside co-morbid health issues. Our results suggest multi-dimensional health assessments coupled with harm reduction in community settings, with appropriate linkage to care, are warranted for PWUD. Service commissioners should seek to integrate these assessments where possible.
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Affiliation(s)
- Christopher J Byrne
- Division of Molecular and Clinical Medicine, University of Dundee, Dundee, Scotland; Directorate of Public Health, Kings Cross Hospital, NHS Tayside, Dundee, Scotland.
| | - Andrew Radley
- Division of Molecular and Clinical Medicine, University of Dundee, Dundee, Scotland; Directorate of Public Health, Kings Cross Hospital, NHS Tayside, Dundee, Scotland
| | - Emma Fletcher
- Directorate of Public Health, Kings Cross Hospital, NHS Tayside, Dundee, Scotland
| | - Donna Thain
- Directorate of Public Health, Kings Cross Hospital, NHS Tayside, Dundee, Scotland
| | - Brian P Stephens
- Department of Gastroenterology, Ninewells Hospital and Medical School, NHS Tayside, Dundee, Scotland
| | - John F Dillon
- Division of Molecular and Clinical Medicine, University of Dundee, Dundee, Scotland; Department of Gastroenterology, Ninewells Hospital and Medical School, NHS Tayside, Dundee, Scotland
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11
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Gunn J, O'Keefe D, Draper BL, Djordjevic F, Ryan K, Kerr P, Elsum I, Gold J, Layton C, Chan K, Dietze P, Higgs P, Doyle J, Stoové MA, Hellard M, Pedrana A. The eliminate hepatitis C (EC) experience study: baseline characteristics of a cohort of people who inject drugs in Melbourne, Australia. BMJ Open 2023; 13:e071665. [PMID: 37400235 DOI: 10.1136/bmjopen-2023-071665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/05/2023] Open
Abstract
OBJECTIVES Direct-acting antivirals provide an opportunity to eliminate hepatitis C virus (HCV) as a public health threat in Australia, yet barriers to care remain. In this study, we use baseline data from a longitudinal cohort of people who inject drugs to understand differences in participant characteristics and explore experiences of stigma, health service utilisation and health literacy between three care cascade groups. DESIGN Cross-sectional. SETTING Community and private primary healthcare services in Melbourne, Australia. PARTICIPANTS Participants completed baseline surveys between 19 September 2018 and 15 December 2020. We recruited 288 participants; the median age was 42 years (IQR: 37-49 years) and 198 (69%) were male. At baseline, 103 (36%) self-reported being 'not engaged in testing', 127 (44%) had HCV RNA positivity but were 'not engaged in treatment' and 58 (20%) were 'engaged in HCV treatment'. OUTCOME MEASURES Descriptive statistics were used to present the baseline demographics, health service utilisation and experiences of stigma data. We explored differences in these scales between participant demographics using χ2 test or fisher's exact tests, and differences between health literacy scores using one-way analysis of variance tests. RESULTS A majority were in regular contact with multiple health services, and most had previously been identified as at-risk of HCV. In the 12 months preceding baseline, 70% reported any experiences of stigma related to injecting drug use. Assessment of health literacy data identified gaps for those 'not engaged in testing' and 'not engaged in treatment' across two relevant domains: 'ability to appraise health information' and 'ability to actively engage with healthcare providers'. CONCLUSION In eliminate hepatitis C experience, lower HCV testing and treatment may be explained by experiences of stigmatisation or gaps in health literacy. Enhanced interventions targeting people who inject drugs to promote HCV care are needed.
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Affiliation(s)
- Jack Gunn
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Daniel O'Keefe
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Bridget Louise Draper
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Filip Djordjevic
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Kathleen Ryan
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Phoebe Kerr
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Imogen Elsum
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Judy Gold
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Chloe Layton
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Kico Chan
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Paul Dietze
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Peter Higgs
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Victoria, Australia
- Department of Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Joseph Doyle
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Mark A Stoové
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Margaret Hellard
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Department of Infectious Diseases, The Alfred and Monash University, Melbourne, Victoria, Australia
- Doherty Institute and Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Alisa Pedrana
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
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12
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Happell B, Furness T, Jacob A, Stimson A, Curtis J, Watkins A, Platania-Phung C, Scholz B, Stanton R. Nurse-Led Physical Health Interventions for People with Mental Illness: A Scoping Review of International Literature. Issues Ment Health Nurs 2023:1-16. [PMID: 37294933 DOI: 10.1080/01612840.2023.2212772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
People with mental illness have a higher prevalence of co-occurring physical health conditions and poor health behaviors, leading a mortality gap of up to 16 years, compared with the general population. Nurses working in mental health settings play an important role in addressing factors influencing sub-optimal physical health. Therefore, this scoping review aimed to identify nurse-led physical health interventions and align interventions to eight recognized physical healthcare priority areas (i.e. Equally Well in Victoria Framework). A systematic search strategy was used to identify relevant literature. Data extraction included alignment to the Equally Well priority areas, research design, and indication of co-design (meaningful and collaborative involvement of consumers and significant others) and recovery-oriented practice (focusing on needs and goals of a consumer's recovery journey). All included papers (n = 74) were aligned to at least one of eight Equally Well priority areas. Papers were predominately quantitative (n = 64, 86%), with the remainder mixed methods (n = 9, 9%) or qualitative (n = 4, 5%). Most papers were aligned to improving metabolic health and support to quit smoking. One study focused on nurse-led intervention designed to reduce falls. Recovery-oriented practice was evident in six papers. No paper described evidence of co-design. A research gap was identified for nurse-led intervention to reduce falls and improve dental/oral care. Relative to mental healthcare policy, there is a need for future nurse-led physical health research to be co-designed and include recovery-oriented practice. Evaluation and description of future nurse-led physical interventions should seek to report perspectives of key stakeholders as these remain relatively unknown.
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Affiliation(s)
- Brenda Happell
- Mental Health and Psychosocial Well-being Theme, Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | | | - Alycia Jacob
- School of Nursing and Midwifery, Australian Catholic University, Fitzroy, Australia
| | - Alisa Stimson
- School of Nursing, Midwifery and Social Sciences, CQUniversity, Rockhampton, Queensland, Australia
| | - Jackie Curtis
- Mindgardens Neuroscience Network, South East Sydney Local Health District, University of New South Wales - Cliffbrook Campus, Coogee, Australia
| | - Andrew Watkins
- Mindgardens Neuroscience Network, South East Sydney Local Health District, University of New South Wales - Cliffbrook Campus, Coogee, Australia
| | | | - Brett Scholz
- Medical School, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Robert Stanton
- Cluster for Resilience and Wellbeing, Appleton Institute, Rockhampton, South Australia, Australia
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Queensland, Australia
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13
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Roder C, Cosgrave C, Mackie K, Roberts SK, Hellard ME, Wade AJ, Doyle JS. Leave No-One Behind: A Retrospective Study of Hepatitis C Testing and Linkage to Care for Hospital Inpatients. Viruses 2023; 15:v15040913. [PMID: 37112893 PMCID: PMC10141486 DOI: 10.3390/v15040913] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/28/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023] Open
Abstract
Hospital admissions are a missed opportunity to engage people living with hepatitis C virus (HCV) into care. This study aimed to describe the proportion of hospital inpatients and emergency department (ED) patients identified with hepatitis C who were subsequently linked to care and treatment at a metropolitan health service in Melbourne, Australia. Data were collected retrospectively from hospital databases (admissions, notifiable diseases, and pharmacy) for all adults admitted or attending the ED with separation coding indicating hepatitis C infection from March 2016 to March 2019. There were 2149 patients with at least one separation with hepatitis C coding. 15.4% (331/2149) had a documented antibody test, 4.6% (99/2149) had a documented RNA test, and 8.3% (179/2149) had a DAA prescription dispensed by hospital pharmacy. Antibody positivity was 95.2% (315/331) and RNA (when completed) was detected in 37.4% (37/99). Hepatitis specialist units had the highest rate of hepatitis C coded separations and RNA testing (39/88; 44.3%), mental health had the highest rate of antibody testing (70/276; 25.4%). Emergency had the lowest rate of antibody testing (101/1075; 13.7%) and the third highest rate of RNA testing (32/94; 34.1%), but the highest rate of RNA detected (15/32; 46.9%). This study highlights key steps to improve the care cascade. Simplified diagnostic pathways, expansion of hepatitis C care services, and clear in-hospital pathways to link patients to care would be beneficial in this setting. To scale up hepatitis C testing and treatment as part of national elimination strategies, hospital systems need to target interventions to their local data.
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Affiliation(s)
- Christine Roder
- Disease Elimination Program, Burnet Institute, Melbourne 3004, Australia
- Centre for Innovation in Infectious Disease and Immunology Research (CIIDIR), Deakin University, Geelong 3220, Australia
- Barwon South West Public Health Unit, Barwon Health, Geelong 3220, Australia
| | - Carl Cosgrave
- Barwon South West Public Health Unit, Barwon Health, Geelong 3220, Australia
| | - Kathryn Mackie
- Barwon South West Public Health Unit, Barwon Health, Geelong 3220, Australia
| | - Stuart K. Roberts
- Department of Gastroenterology, Alfred Health and Monash University, Melbourne 3004, Australia
| | | | - Amanda J. Wade
- Disease Elimination Program, Burnet Institute, Melbourne 3004, Australia
- Centre for Innovation in Infectious Disease and Immunology Research (CIIDIR), Deakin University, Geelong 3220, Australia
- Barwon South West Public Health Unit, Barwon Health, Geelong 3220, Australia
| | - Joseph S. Doyle
- Disease Elimination Program, Burnet Institute, Melbourne 3004, Australia
- Department of Infectious Disease, Alfred Health and Monash University, Melbourne 3004, Australia
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14
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MacIsaac MB, Whitton B, Hubble A, Cogger S, Penn M, Weeks A, Elmore K, Pemberton D, Anderson J, Howard R, McKeever U, Papaluca T, Hellard ME, Stoove M, Wilson D, Pedrana A, Doyle J, Clark N, Holmes J, Thompson AJ. Eliminating hepatitis C in Australia: a novel model of hepatitis C testing and treatment for people who inject drugs at a medically supervised injecting facility. Med J Aust 2023; 218:256-261. [PMID: 36919230 DOI: 10.5694/mja2.51885] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/17/2023] [Accepted: 01/27/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE To evaluate the feasibility of testing and treating people who inject drugs at a supervised injecting facility for hepatitis C virus (HCV) infection. DESIGN Retrospective cohort study. SETTING, PARTICIPANTS People who inject drugs who attended the Melbourne supervised injecting facility, 30 June 2018 - 30 June 2020. MAIN OUTCOME MEASURES Proportion of people tested for hepatitis C; proportions of people positive for anti-HCV antibody and HCV RNA, and of eligible people prescribed direct-acting antiviral (DAA) treatment; sustained virological response twelve weeks or more after treatment completion. RESULTS Of 4649 people who attended the supervised injecting facility during 2018-20, 321 were tested for hepatitis C (7%); 279 were anti-HCV antibody-positive (87%), of whom 143 (51%) were also HCV RNA-positive. Sixty-four of 321 had previously been treated for hepatitis C (20%), 21 had clinically identified cirrhosis (7%), eight had hepatitis B infections (2%), and four had human immunodeficiency virus infections (1%). In multivariate analyses, people tested for hepatitis C were more likely than untested clients to report psychiatric illness (adjusted odds ratio [aOR], 9.65; 95% confidence interval [CI], 7.26-12.8), not have a fixed address (aOR, 1.59; 95% CI, 1.18-2.14), and to report significant alcohol use (aOR, 1.57; 95% CI, 1.06-2.32). The median number of injecting facility visits was larger for those tested for hepatitis C (101; interquartile range [IQR], 31-236) than for those not tested (20; IQR, 3-90). DAA treatment was prescribed for 126 of 143 HCV RNA-positive clients (88%); 41 of 54 with complete follow-up data were cured (76%). CONCLUSIONS People who attend supervised injecting facilities can be tested and treated for hepatitis C on site. Models that provide streamlined, convenient hepatitis C care promote engagement with treatment in a group in which the prevalence of hepatitis C is high.
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Affiliation(s)
- Michael B MacIsaac
- St Vincent's Hospital Melbourne, Melbourne, VIC.,The University of Melbourne, Melbourne, VIC
| | | | | | | | | | | | | | | | | | | | | | - Timothy Papaluca
- St Vincent's Hospital Melbourne, Melbourne, VIC.,The University of Melbourne, Melbourne, VIC
| | - Margaret E Hellard
- The Burnet Institute, Melbourne, VIC.,Monash University, Melbourne, VIC.,Alfred Health, Melbourne, VIC
| | - Mark Stoove
- The Burnet Institute, Melbourne, VIC.,Monash University, Melbourne, VIC
| | | | - Alisa Pedrana
- The Burnet Institute, Melbourne, VIC.,Monash University, Melbourne, VIC
| | - Joseph Doyle
- The Burnet Institute, Melbourne, VIC.,Alfred Health, Melbourne, VIC
| | - Nico Clark
- North Richmond Community Health, Melbourne, VIC.,The Royal Melbourne Hospital, Melbourne, VIC
| | - Jacinta Holmes
- St Vincent's Hospital Melbourne, Melbourne, VIC.,The University of Melbourne, Melbourne, VIC
| | - Alexander J Thompson
- St Vincent's Hospital Melbourne, Melbourne, VIC.,The University of Melbourne, Melbourne, VIC
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15
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Searby A, Burr D, Blums C, Harrison J, Smyth D. Barriers and facilitators to becoming an alcohol and other drug nurse practitioner in Australia: A mixed methods study. Int J Ment Health Nurs 2023; 32:839-853. [PMID: 36744685 DOI: 10.1111/inm.13125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 02/07/2023]
Abstract
Alcohol and other drug (AOD) nurse practitioners have an advanced scope of practice that allows them to diagnose, prescribe pharmacological treatments for alcohol and other substance use disorders, and monitor physical and mental health. The Behaviour Change Wheel (BCW) is used to understand barriers and facilitators to implementation by applying three conditions of behaviour change (capability, opportunity, and motivation-the COM-B framework). The aim of this paper is to describe the current AOD nurse practitioner workforce, and to explore barriers and facilitators to AOD nurse practitioner uptake in Australia. A mixed method approach was used in this study: a survey to determine the current state of the AOD nurse practitioner workforce (n = 41) and qualitative interviews with 14 participants to determine barriers to endorsement and ongoing work as a nurse practitioner. Interview transcripts were analysed using thematic analysis and mapped to the COM-B framework. The AOD nurse practitioner is a highly specialized provider of holistic care to people who use alcohol and other drugs, with AOD nurse practitioners performing advanced roles such as prescribing and medication management. However, there are several barriers to the further uptake of AOD nurse practitioners in Australia, including varied organizational support, a lack of support for the higher study required to become a nurse practitioner and a lack of available positions. Arguably, nurse practitioners are key to addressing prescriber shortages inherent in AOD treatment settings. In addition, they are equipped to provide true holistic care. We recommend that barriers are addressed to expand the AOD nurse practitioner workforce in Australia.
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Affiliation(s)
- Adam Searby
- Institute for Health Transformation, School of Nursing & Midwifery, Deakin University, Geelong, Victoria, Australia
- Drug and Alcohol Nurses of Australasia (DANA), Brisbane, Queensland, Australia
| | - Dianna Burr
- Institute for Health Transformation, School of Nursing & Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Colleen Blums
- Drug and Alcohol Nurses of Australasia (DANA), Brisbane, Queensland, Australia
| | - Jason Harrison
- Drug and Alcohol Nurses of Australasia (DANA), Brisbane, Queensland, Australia
- Central Queensland Mental Health, Alcohol and Other Drug Service, Rockhampton, Queensland, Australia
| | - Darren Smyth
- Drug and Alcohol Nurses of Australasia (DANA), Brisbane, Queensland, Australia
- Queensland Injectors Health Network (QuINH), Gold Coast, Queensland, Australia
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16
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Awareness of HCV Status and Preferences for Testing and Treatment among People with Recent Injecting Drug Use at a Peer-Led Needle and Syringe Program: The TEMPO Pilot Study. Viruses 2022; 14:v14112463. [PMID: 36366561 PMCID: PMC9696805 DOI: 10.3390/v14112463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/26/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND New technologies and therapies allow the possibility of a single-visit test and treat model for hepatitis C virus (HCV), addressing some of the barriers to care faced by people who inject drugs. METHODS The TEMPO Pilot Study was an interventional cohort study evaluating a single-visit test and treat intervention among people with recent injecting drug use at a one peer-led needle and syringe program (NSP) in Sydney, Australia between September 2019 and February 2021. This analysis evaluated awareness of HCV status and agreement of self-report with HCV RNA test results. The analysis also assessed acceptability of: modality of result delivery, modality of blood sampling, site of treatment, and duration of treatment. RESULTS Among 101 participants (median age 43; 31% female), 100 had a valid HCV RNA test result and 27% (27/100) were HCV RNA detectable. Overall, 65% (65/100) were aware of their status. Among people with a positive HCV RNA result, 48% (13/27) were aware of their status. People preferred same-day HCV test results (95%, 96/101), and preferred to receive results in person (69%, 70/101). Receiving treatment at an NSP was acceptable (100%, 101/101) and 78% (79/101) were willing to discuss their health with a peer NSP worker. CONCLUSION Half of people with current HCV infection were aware of their status. The high acceptability of simplified testing and treatment pathways delivered at NSPs indicates that this is an appropriate strategy to improve HCV awareness and treatment uptake in this population.
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17
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Braude M, Khaira G, Woolley I, Clarke D, Dev A, Sievert W. Integrating Hepatitis C Virus Treatment Programs Within Community Mental Health. Psychiatr Serv 2022; 73:946-949. [PMID: 34991342 DOI: 10.1176/appi.ps.202100375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Conventional models of health care for the hepatitis C virus (HCV) underserve people with serious mental illness. In a 6-month proof-of-concept study, colocated HCV care coordination was assessed within community mental health settings. The program, which relied on referrals to a visiting hepatologist and was augmented by a part-time nurse practitioner, received 18 referrals for HCV management. From this group, 11 individuals achieved sustained virological response at 12 weeks after direct-acting antiviral therapy. Seven individuals declined treatment or were lost to follow-up. Overall, colocated integrated services may play an important role in HCV health care parity for people with serious mental illness.
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Affiliation(s)
- Michael Braude
- Monash Health, Clayton, Victoria, Australia (Braude, Khaira, Woolley, Dev, Sievert); School of Clinical Sciences (Baude, Woolley, Dev, Sievert) and Psychological Medicine (Clarke),Monash University, Clayton, Victoria, Australia. Benjamin G. Druss, M.D., M.P.H., and Gail Daumit, M.D., M.H.S., are editors of this column
| | - Gaganpreet Khaira
- Monash Health, Clayton, Victoria, Australia (Braude, Khaira, Woolley, Dev, Sievert); School of Clinical Sciences (Baude, Woolley, Dev, Sievert) and Psychological Medicine (Clarke),Monash University, Clayton, Victoria, Australia. Benjamin G. Druss, M.D., M.P.H., and Gail Daumit, M.D., M.H.S., are editors of this column
| | - Ian Woolley
- Monash Health, Clayton, Victoria, Australia (Braude, Khaira, Woolley, Dev, Sievert); School of Clinical Sciences (Baude, Woolley, Dev, Sievert) and Psychological Medicine (Clarke),Monash University, Clayton, Victoria, Australia. Benjamin G. Druss, M.D., M.P.H., and Gail Daumit, M.D., M.H.S., are editors of this column
| | - David Clarke
- Monash Health, Clayton, Victoria, Australia (Braude, Khaira, Woolley, Dev, Sievert); School of Clinical Sciences (Baude, Woolley, Dev, Sievert) and Psychological Medicine (Clarke),Monash University, Clayton, Victoria, Australia. Benjamin G. Druss, M.D., M.P.H., and Gail Daumit, M.D., M.H.S., are editors of this column
| | - Anouk Dev
- Monash Health, Clayton, Victoria, Australia (Braude, Khaira, Woolley, Dev, Sievert); School of Clinical Sciences (Baude, Woolley, Dev, Sievert) and Psychological Medicine (Clarke),Monash University, Clayton, Victoria, Australia. Benjamin G. Druss, M.D., M.P.H., and Gail Daumit, M.D., M.H.S., are editors of this column
| | - William Sievert
- Monash Health, Clayton, Victoria, Australia (Braude, Khaira, Woolley, Dev, Sievert); School of Clinical Sciences (Baude, Woolley, Dev, Sievert) and Psychological Medicine (Clarke),Monash University, Clayton, Victoria, Australia. Benjamin G. Druss, M.D., M.P.H., and Gail Daumit, M.D., M.H.S., are editors of this column
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18
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Harney BL, Whitton B, Paige E, Brereton R, Weiss R, Membrey D, Wade AJ, Iser D, Kemp W, Roberts SK, Spelman T, Sacks-Davis R, Hellard ME, Doyle JS. A multi-site, nurse-coordinated hepatitis C model of care in primary care and community services in Melbourne, Australia. Liver Int 2022; 42:522-531. [PMID: 34821021 DOI: 10.1111/liv.15107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/10/2021] [Accepted: 11/18/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Hepatitis C virus (HCV) treatment through primary care and community-based services will be a critical component of HCV elimination. We evaluated a nurse-coordinated programme providing care across eight sites and analysed progression through the HCV care cascade. METHODS People-accessing services from six primary care clinics, a homeless crisis accommodation provider and a mental health service were directly referred to nurses or engaged by nurses during regular clinic visits. Nurses supported HCV testing, treatment and follow-up. The prescription was provided by affiliated clinicians. Logistic regression was used to examine factors associated with treatment commencement and sustained virological response (SVR) testing. RESULTS Of 640 people referred to and/or engaged by the nurses from January 2017 to July 2019, 518 had an HCV RNA test of whom 381 (74%) were HCV RNA positive. Treatment was commenced by 281 (74%) people of whom 161 had an SVR test, 157 (97.5%) were cured. Opioid agonist therapy was associated with treatment commencement (aOR 2.68, 95% CI 1.48-4.88). People who were homeless/unstably housed were less likely to commence treatment (aOR 0.45, 95% CI 0.23-0.87). Treatment prescription from a specialist (aOR 2.39, 95% CI 1.20-4.74) and recent injection drug use (<6 months) (aOR 2.15, 95% CI 1.07-4.31) was associated with SVR testing. CONCLUSION A nurse-coordinated model of care led to high levels of HCV treatment uptake and cure amongst people attending primary care and community services. More tailored models of care may be beneficial for people who are homeless or have unstable housing. These results support primary care and community-based hepatitis C treatment.
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Affiliation(s)
- Brendan L Harney
- Department of Infectious Diseases, Alfred Health & Monash University, Melbourne, Australia.,Disease Elimination Program, Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Bradley Whitton
- Department of Infectious Diseases, Alfred Health & Monash University, Melbourne, Australia
| | - Emma Paige
- Department of Infectious Diseases, Alfred Health & Monash University, Melbourne, Australia
| | - Rebecca Brereton
- St Kilda Road Clinic & South City Clinic, Alfred Community Mental & Addiction Health, Melbourne, Australia
| | | | | | - Amanda J Wade
- Disease Elimination Program, Burnet Institute, Melbourne, Australia.,Department of Infectious Diseases, Barwon Health, Geelong, Australia
| | - David Iser
- Department of Infectious Diseases, Alfred Health & Monash University, Melbourne, Australia.,Department of Medicine, University of Melbourne, Melbourne, Australia
| | - William Kemp
- Department of Gastroenterology, Alfred Health, Melbourne, Australia.,Department of Medicine, Monash University, Melbourne, Australia
| | - Stuart K Roberts
- Department of Gastroenterology, Alfred Health, Melbourne, Australia.,Department of Medicine, Monash University, Melbourne, Australia
| | - Tim Spelman
- Disease Elimination Program, Burnet Institute, Melbourne, Australia
| | - Rachel Sacks-Davis
- Disease Elimination Program, Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Margaret E Hellard
- Department of Infectious Diseases, Alfred Health & Monash University, Melbourne, Australia.,Disease Elimination Program, Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Doherty Institute and School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Joseph S Doyle
- Department of Infectious Diseases, Alfred Health & Monash University, Melbourne, Australia.,Disease Elimination Program, Burnet Institute, Melbourne, Australia
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19
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Lakhani A, Wollersheim D. COVID-19 test sites in Victoria approaching Stage 4 restrictions: evaluating the relationship between remoteness, travel time and population serviced. Aust N Z J Public Health 2021; 45:628-636. [PMID: 34709703 PMCID: PMC8652517 DOI: 10.1111/1753-6405.13154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/01/2021] [Accepted: 07/01/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE In Australia, people residing remotely typically experience increased travel time to health services, and remote health services often have unfavourable population-to-provider ratios. The state of Victoria was treated as a case study and a spatial analysis investigated the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) point-of-care-test (POCT) site location (Major City, Inner Regional or Outer Regional) on the mean travel time for closest residents and the number of closest residents. METHODS A network analysis established the travel time from every mesh block in Victoria to the closest POCT site. Inferential analyses investigated the impact of POCT site location on travel time and the number of closest residents. RESULTS Compared to urban locations, the mean travel time for closest residents to rural POCT sites was significantly higher, while rural POCT sites had significantly fewer residents to service. CONCLUSIONS Findings confirm Australian health service literature suggesting that rural regions have poorer proximate availability of health services, while also contrasting to literature indicating that Australian rural regions have fewer health services per capita. Implications for public health: Localities within outer regional Victoria are candidates for a localised response to reduce unnecessary travel. Employing innovative service models may improve health service access and use and reduce population-to-provider ratios in rural locations.
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Affiliation(s)
- Ali Lakhani
- School of Psychology and Public Health, La Trobe University, Victoria,The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Queensland,Correspondence to: Dr Ali Lakhani, The School of Psychology and Public Health, La Trobe University, Room 3.06, 360 Collins Street, Melbourne, VIC, 3000
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20
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Harney BL, Brereton R, Whitton B, Pietrzak D, Paige E, Roberts SK, Birks S, Saraf S, Hellard ME, Doyle JS. Letter in response: Psychiatrists can treat hepatitis C. J Viral Hepat 2021; 28:1765-1766. [PMID: 34582615 DOI: 10.1111/jvh.13619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 09/13/2021] [Indexed: 12/09/2022]
Affiliation(s)
- Brendan L Harney
- Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Vic., Australia.,Burnet Institute, Disease Elimination Program, Melbourne, Vic., Australia
| | - Rebecca Brereton
- Alfred Community Mental & Addiction Health, St Kilda Road & Southcity Clinic, Melbourne, Vic., Australia
| | - Bradley Whitton
- Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Vic., Australia
| | - Danusia Pietrzak
- Alfred Community Mental & Addiction Health, St Kilda Road & Southcity Clinic, Melbourne, Vic., Australia
| | - Emma Paige
- Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Vic., Australia
| | - Stuart K Roberts
- Department of Gastroenterology, Alfred Health, Melbourne, Vic., Australia.,Department of Medicine, Monash University, Melbourne, Vic., Australia
| | - Susanne Birks
- Alfred Community Mental & Addiction Health, St Kilda Road & Southcity Clinic, Melbourne, Vic., Australia
| | - Sudeep Saraf
- Alfred Community Mental & Addiction Health, St Kilda Road & Southcity Clinic, Melbourne, Vic., Australia
| | - Margaret E Hellard
- Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Vic., Australia.,Burnet Institute, Disease Elimination Program, Melbourne, Vic., Australia
| | - Joseph S Doyle
- Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Vic., Australia.,Burnet Institute, Disease Elimination Program, Melbourne, Vic., Australia
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21
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Roder C, Nguyen P, Harvey C, Wardrop M, Finlay J, Ogunleye L, Hill H, Athan E, Wade AJ. Psychiatrists can treat hepatitis C. J Viral Hepat 2021; 28:1763-1764. [PMID: 34582612 DOI: 10.1111/jvh.13622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 09/13/2021] [Indexed: 12/09/2022]
Affiliation(s)
- Christine Roder
- Department of Infectious Diseases, Barwon Health, University Hospital Geelong, Geelong, Victoria, Australia.,Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia.,Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, School of Medicine, Waurn Ponds, Victoria, Australia
| | - Paul Nguyen
- Department of Medicine, Barwon Health, University Hospital Geelong, Geelong, Victoria, Australia
| | - Craig Harvey
- Harm Reduction Services, Geelong, Victoria, Australia
| | - Margaret Wardrop
- Department of Infectious Diseases, Barwon Health, University Hospital Geelong, Geelong, Victoria, Australia
| | - Jane Finlay
- Harm Reduction Services, Geelong, Victoria, Australia
| | - Lekan Ogunleye
- Mental Health Drugs and Alcohol Service, Geelong, Victoria, Australia
| | - Harry Hill
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, School of Medicine, Waurn Ponds, Victoria, Australia.,Mental Health Drugs and Alcohol Service, Geelong, Victoria, Australia
| | - Eugene Athan
- Department of Infectious Diseases, Barwon Health, University Hospital Geelong, Geelong, Victoria, Australia.,Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, School of Medicine, Waurn Ponds, Victoria, Australia
| | - Amanda J Wade
- Department of Infectious Diseases, Barwon Health, University Hospital Geelong, Geelong, Victoria, Australia.,Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
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