Posted on October 18, 2015
The American Journal Of Medicine
Given the safety, tolerability, simplicity, and efficacy of hepatitis C direct-acting antiviral (DAA) regimens, decentralizing treatment from gastroenterologists and hepatologists to other specialists, community-based primary care physicians, or appropriately supervised mid-level providers (ie, task-shifting) may be an effective strategy to increase treatment rates, cure rates, and really start addressing to the HCV epidemic. The SVR-12 rates achieved by a US rural outreach program based on the task-shifting model—88 % overall, 86 % in genotype 1 patients, 94 % in genotype 2 patients, and 83 % in genotype 3 patients—are comparable to those achieved in phase II and III clinical trials utilizing these regimens. By utilizing task-shifting, wherein a local mid-level provider monitored patients on DAA treatment with indirect supervision of a specialist, high rates of treatment adherence and success in medically underserved areas was achieved.
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