Transforming the Cascade Of Hepatitis C Care
Transforming the Cascade of Hepatitis C Care
Several factors are barriers to effective Hepatitis C care: 1) The majority of Hepatitis C Virus (HCV)-positive patients (45-85 percent) are unaware that they are infected; 2) Only a small minority of those in need of treatment receive it; 3) Members of minorities and older patients are even less likely to receive needed care; and 4) Until recently, even those who were treated had a low chance of clearing the virus or achieving cure; 5) It is possible that older attitudes and expectation of futility might continue to persist among patients and provider in primary care settings.
Community Health Centers are often the most culturally appropriate and accessible choices, particularly for underserved populations, with the benefit of ongoing trust and relationships with patients. Therefore, these can be ideal places to deliver complex HCV care if they possess the needed expertise. However, most community-based primary care and community health centers lack access to Hepatitis C evaluation and treatment services, leading to a major public health problem.
Thus, investigators propose to implement and evaluate a pragmatic trial to implement and evaluate a multi-disciplinary model for HCV treatment at Currently, the treatment initiation rates at each of these sites is estimated as less than 10%. The investigators hypothesize that our project will increase the rate of participation in all the steps of the HCV care cascade and ultimately lead to more than doubled rates of treatment uptake
Visão geral do estudo
Status
Condições
Descrição detalhada
Primary Objective:
Determine uptake, effectiveness and safety of IFN-free, DAAs among "real world" patients, including those with multiple comorbidities, in the primary care setting.
Secondary Objective(s):
- Demonstrate the transformation of the cascade of Hepatitis C Care at 3 primary care clinics in terms of changes from baseline in rates for rates of access to HCV care including HCV screening, evaluation, treatment consideration, treatment uptake, completion, loss to follow-up, and treatment success rate.
- Advance understanding of hepatitis C related decision-making in the era of Interferon (IFN)-free Direct acting agents (DAAs) by examining the context, needs, motivators, barriers, and preferences among patients and providers to the delivery of hepatitis C treatment at primary care clinics
Tipo de estudo
Inscrição (Real)
Contactos e Locais
Locais de estudo
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Pennsylvania
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Pittsburgh, Pennsylvania, Estados Unidos, 15232
- UPMC Shadyside Family Health Center
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Método de amostragem
População do estudo
Descrição
Inclusion Criteria:
- All patients with detectable HCV RNA level, currently receiving care at any of these three community health centers
Exclusion Criteria:
- Criteria for automatic specialty referral (exclusion from treatment at community health centers) Child Turcotte Pugh Class B or C Any history of decompensated liver disease or hepatocellular carcinoma Evidence of renal disease (GFR <50) or coexisting autoimmune condition HIV of hepatitis B co-infection
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Modelos de observação: Outro
- Perspectivas de Tempo: Prospectivo
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Percentage of patients achieving sustained viral response 12 weeks post treatment (SVR 12) over a three year intervention period.
Prazo: three years
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measure percentage of patients moving through the cascade of care to cure of condition (SVR 12)
|
three years
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Rates of Hepatitis C Virus (HCV) screening
Prazo: three years
|
Percentage of at risk patients in the practice who have a completed HCV antibody test
|
three years
|
|
Rate of Chronic Hepatitis C evaluation
Prazo: three years
|
Percentage of patients with a positive HCV antibody test who have a HCV polymerase chain reaction (PCR) viral load completed
|
three years
|
|
Rate of treatment consideration
Prazo: three years
|
Percentage of consented patients with a positive HCV viral load who have a clinical evaluation and assessment of psychosocial readiness for treatment documented in the medical record
|
three years
|
|
Rate of treatment uptake
Prazo: three years
|
Percentage of patients recommended for treatment who begin medical treatment
|
three years
|
|
Rate of treatment completion
Prazo: three years
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Percentage of patients that began treatment who complete the recommended course of therapy
|
three years
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Rate of patients lost to follow up
Prazo: three years
|
Percent of consented patients with a positive HCV viral load who are lost to follow up
|
three years
|
|
Hepatitis C capacity building among family medicine physicians (provider practice and perceived confidence):
Prazo: three years
|
Endpoints related to HCV capacity building among family medicine physicians: Evaluate comfort and skill among family physicians to evaluate and treat HCV infection as measured on a qualitative survey of physicians
|
three years
|
Colaboradores e Investigadores
Patrocinador
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Doenças do aparelho digestivo
- Infecções por vírus de RNA
- Doenças Virais
- Infecções
- Infecções transmitidas pelo sangue
- Doenças Transmissíveis
- Doenças do Fígado
- Infecções por Flaviviridae
- Hepatite, Viral, Humana
- Infecções por Enterovírus
- Infecções por Picornaviridae
- Hepatite Crônica
- Hepatite
- Hepatite A
- Hepatite C
- Hepatite C Crônica
Outros números de identificação do estudo
- PRO16040427
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
Informações sobre medicamentos e dispositivos, documentos de estudo
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Ensaios clínicos em Hepatite C Crônica
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Ohio State UniversityRecrutamentoStatus adequado de vitamina C | Status inadequado de vitamina CEstados Unidos
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Dokuz Eylul UniversityEge UniversityConcluídoMMP9 | TIMP1 | MMP9 -1562 C/T | TIMP1 372 T/CPeru
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BioGaia ABAureviaAinda não está recrutando
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Zhongnan HospitalRecrutamento
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University College CorkDupont Applied BiosciencesRecrutamento
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TCI Co., Ltd.Concluído
-
Trek Therapeutics, PBCConcluídoHepatite C crônica | Hepatite C Genótipo 1 | Hepatite C (VHC) | Infecção viral da hepatite CEstados Unidos, Nova Zelândia
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Trek Therapeutics, PBCConcluídoHepatite C crônica | Hepatite C (VHC) | Hepatite C Genótipo 4 | Infecção viral da hepatite CEstados Unidos
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Hadassah Medical OrganizationXTL BiopharmaceuticalsRetiradoInfecção Crônica pelo Vírus da Hepatite CIsrael