Using telehealth to improve access to hepatitis C treatment in the direct-acting antiviral therapy era
Introduction One-third of the Australian population lives outside major cities and this group has worse health outcomes. Telehealth is becoming an accepted way to improve patient access to specialist healthcare. Over 200,000 Australian’s have hepatitis C virus (HCV) and new treatments are very effec...
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Veröffentlicht in: | Journal of telemedicine and telecare 2020-04, Vol.26 (3), p.180-185 |
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creator | Schulz, Thomas R Kanhutu, Kudzai Sasadeusz, Joseph Watkinson, Sally Biggs, Beverley-Ann |
description | Introduction
One-third of the Australian population lives outside major cities and this group has worse health outcomes. Telehealth is becoming an accepted way to improve patient access to specialist healthcare. Over 200,000 Australian’s have hepatitis C virus (HCV) and new treatments are very effective and well tolerated. We aim to demonstrate that HCV treatment utilising telehealth support for care delivery has cure rates similar to onsite care in clinical trials. We also report length of consultation and calculate reductions in travel and carbon output.
Methods
Patient demographic, clinical, and treatment outcome data were collected prospectively from hospital software and analysed retrospectively. This was an audit of all patients treated for HCV in one year from a single tertiary hospital that included telehealth in their care delivery.
Results
Sustained virological response was achieved in 51/52 (98%) patients with completed treatment courses, and 51/58 (88%) of those who had a planned telehealth consultation as part of their management. A median of 634 km of patient travel was saved per telehealth consultation.
Discussion
We found that a telehealth-supported outreach programme for patients in regional Australia with HCV produced similar outcomes to clinical trials. There was a considerable saving in time and cost for the patients and significant environmental benefit through the reduction in carbon footprint associated with travel to distant specialist health services. We conclude that telehealth facilitated outreach is a feasible and effective way to access HCV treatment and cure in regional Australia. |
doi_str_mv | 10.1177/1357633X18806651 |
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One-third of the Australian population lives outside major cities and this group has worse health outcomes. Telehealth is becoming an accepted way to improve patient access to specialist healthcare. Over 200,000 Australian’s have hepatitis C virus (HCV) and new treatments are very effective and well tolerated. We aim to demonstrate that HCV treatment utilising telehealth support for care delivery has cure rates similar to onsite care in clinical trials. We also report length of consultation and calculate reductions in travel and carbon output.
Methods
Patient demographic, clinical, and treatment outcome data were collected prospectively from hospital software and analysed retrospectively. This was an audit of all patients treated for HCV in one year from a single tertiary hospital that included telehealth in their care delivery.
Results
Sustained virological response was achieved in 51/52 (98%) patients with completed treatment courses, and 51/58 (88%) of those who had a planned telehealth consultation as part of their management. A median of 634 km of patient travel was saved per telehealth consultation.
Discussion
We found that a telehealth-supported outreach programme for patients in regional Australia with HCV produced similar outcomes to clinical trials. There was a considerable saving in time and cost for the patients and significant environmental benefit through the reduction in carbon footprint associated with travel to distant specialist health services. We conclude that telehealth facilitated outreach is a feasible and effective way to access HCV treatment and cure in regional Australia.</description><identifier>ISSN: 1357-633X</identifier><identifier>EISSN: 1758-1109</identifier><identifier>DOI: 10.1177/1357633X18806651</identifier><identifier>PMID: 30336724</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adult ; Aged ; Antiviral Agents - therapeutic use ; Antiviral drugs ; Australia ; Benzimidazoles - therapeutic use ; Carbamates - therapeutic use ; Clinical trials ; Delivery of Health Care - organization & administration ; Female ; Fluorenes - therapeutic use ; Health Services Accessibility ; Hepatitis ; Hepatitis C ; Hepatitis C - drug therapy ; Humans ; Imidazoles - therapeutic use ; Male ; Middle Aged ; Patients ; Pyrrolidines - therapeutic use ; Retrospective Studies ; Sofosbuvir - therapeutic use ; Telemedicine ; Treatment Outcome ; Valine - analogs & derivatives ; Valine - therapeutic use</subject><ispartof>Journal of telemedicine and telecare, 2020-04, Vol.26 (3), p.180-185</ispartof><rights>The Author(s) 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c407t-d773d00307aea2e36e009cdf2357933e04dd2b934d406ba5d3a1e5985e01e263</citedby><cites>FETCH-LOGICAL-c407t-d773d00307aea2e36e009cdf2357933e04dd2b934d406ba5d3a1e5985e01e263</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1357633X18806651$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1357633X18806651$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30336724$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schulz, Thomas R</creatorcontrib><creatorcontrib>Kanhutu, Kudzai</creatorcontrib><creatorcontrib>Sasadeusz, Joseph</creatorcontrib><creatorcontrib>Watkinson, Sally</creatorcontrib><creatorcontrib>Biggs, Beverley-Ann</creatorcontrib><title>Using telehealth to improve access to hepatitis C treatment in the direct-acting antiviral therapy era</title><title>Journal of telemedicine and telecare</title><addtitle>J Telemed Telecare</addtitle><description>Introduction
One-third of the Australian population lives outside major cities and this group has worse health outcomes. Telehealth is becoming an accepted way to improve patient access to specialist healthcare. Over 200,000 Australian’s have hepatitis C virus (HCV) and new treatments are very effective and well tolerated. We aim to demonstrate that HCV treatment utilising telehealth support for care delivery has cure rates similar to onsite care in clinical trials. We also report length of consultation and calculate reductions in travel and carbon output.
Methods
Patient demographic, clinical, and treatment outcome data were collected prospectively from hospital software and analysed retrospectively. This was an audit of all patients treated for HCV in one year from a single tertiary hospital that included telehealth in their care delivery.
Results
Sustained virological response was achieved in 51/52 (98%) patients with completed treatment courses, and 51/58 (88%) of those who had a planned telehealth consultation as part of their management. A median of 634 km of patient travel was saved per telehealth consultation.
Discussion
We found that a telehealth-supported outreach programme for patients in regional Australia with HCV produced similar outcomes to clinical trials. There was a considerable saving in time and cost for the patients and significant environmental benefit through the reduction in carbon footprint associated with travel to distant specialist health services. We conclude that telehealth facilitated outreach is a feasible and effective way to access HCV treatment and cure in regional Australia.</description><subject>Adult</subject><subject>Aged</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Antiviral drugs</subject><subject>Australia</subject><subject>Benzimidazoles - therapeutic use</subject><subject>Carbamates - therapeutic use</subject><subject>Clinical trials</subject><subject>Delivery of Health Care - organization & administration</subject><subject>Female</subject><subject>Fluorenes - therapeutic use</subject><subject>Health Services Accessibility</subject><subject>Hepatitis</subject><subject>Hepatitis C</subject><subject>Hepatitis C - drug therapy</subject><subject>Humans</subject><subject>Imidazoles - therapeutic use</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Pyrrolidines - therapeutic use</subject><subject>Retrospective Studies</subject><subject>Sofosbuvir - therapeutic use</subject><subject>Telemedicine</subject><subject>Treatment Outcome</subject><subject>Valine - analogs & derivatives</subject><subject>Valine - therapeutic use</subject><issn>1357-633X</issn><issn>1758-1109</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1UE1LAzEQDaLYWr17koDn1clmN9k9SvELCl4qeFvSzWw3Zb9M0kL_vVlaFQQvM8O8N29mHiHXDO4Yk_Ke8VQKzj9YloEQKTshUybTLGIM8tNQBzga8Qm5cG4DELMkzc_JhAPnQsbJlFTvznRr6rHBGlXja-p7atrB9jukqizRubFT46C88cbROfUWlW-x89R01NdItbFY-kiVfpRSnTc7Y1UzYlYNexriJTmrVOPw6phnZPn0uJy_RIu359f5wyIqE5A-0lJyDcBBKlQxcoEAeamrODySc46QaB2vcp7oBMRKpZorhmmepQgMY8Fn5PYgG-7_3KLzxabf2i5sLGKe5SzJuIgDCw6s0vbOWayKwZpW2X3BoBh9Lf76GkZujsLbVYv6Z-DbyECIDgSn1vi79V_BL_xGgCw</recordid><startdate>202004</startdate><enddate>202004</enddate><creator>Schulz, Thomas R</creator><creator>Kanhutu, Kudzai</creator><creator>Sasadeusz, Joseph</creator><creator>Watkinson, Sally</creator><creator>Biggs, Beverley-Ann</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope></search><sort><creationdate>202004</creationdate><title>Using telehealth to improve access to hepatitis C treatment in the direct-acting antiviral therapy era</title><author>Schulz, Thomas R ; Kanhutu, Kudzai ; Sasadeusz, Joseph ; Watkinson, Sally ; Biggs, Beverley-Ann</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c407t-d773d00307aea2e36e009cdf2357933e04dd2b934d406ba5d3a1e5985e01e263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antiviral Agents - therapeutic use</topic><topic>Antiviral drugs</topic><topic>Australia</topic><topic>Benzimidazoles - therapeutic use</topic><topic>Carbamates - therapeutic use</topic><topic>Clinical trials</topic><topic>Delivery of Health Care - organization & administration</topic><topic>Female</topic><topic>Fluorenes - therapeutic use</topic><topic>Health Services Accessibility</topic><topic>Hepatitis</topic><topic>Hepatitis C</topic><topic>Hepatitis C - drug therapy</topic><topic>Humans</topic><topic>Imidazoles - therapeutic use</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Pyrrolidines - therapeutic use</topic><topic>Retrospective Studies</topic><topic>Sofosbuvir - therapeutic use</topic><topic>Telemedicine</topic><topic>Treatment Outcome</topic><topic>Valine - analogs & derivatives</topic><topic>Valine - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schulz, Thomas R</creatorcontrib><creatorcontrib>Kanhutu, Kudzai</creatorcontrib><creatorcontrib>Sasadeusz, Joseph</creatorcontrib><creatorcontrib>Watkinson, Sally</creatorcontrib><creatorcontrib>Biggs, Beverley-Ann</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Journal of telemedicine and telecare</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schulz, Thomas R</au><au>Kanhutu, Kudzai</au><au>Sasadeusz, Joseph</au><au>Watkinson, Sally</au><au>Biggs, Beverley-Ann</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Using telehealth to improve access to hepatitis C treatment in the direct-acting antiviral therapy era</atitle><jtitle>Journal of telemedicine and telecare</jtitle><addtitle>J Telemed Telecare</addtitle><date>2020-04</date><risdate>2020</risdate><volume>26</volume><issue>3</issue><spage>180</spage><epage>185</epage><pages>180-185</pages><issn>1357-633X</issn><eissn>1758-1109</eissn><abstract>Introduction
One-third of the Australian population lives outside major cities and this group has worse health outcomes. Telehealth is becoming an accepted way to improve patient access to specialist healthcare. Over 200,000 Australian’s have hepatitis C virus (HCV) and new treatments are very effective and well tolerated. We aim to demonstrate that HCV treatment utilising telehealth support for care delivery has cure rates similar to onsite care in clinical trials. We also report length of consultation and calculate reductions in travel and carbon output.
Methods
Patient demographic, clinical, and treatment outcome data were collected prospectively from hospital software and analysed retrospectively. This was an audit of all patients treated for HCV in one year from a single tertiary hospital that included telehealth in their care delivery.
Results
Sustained virological response was achieved in 51/52 (98%) patients with completed treatment courses, and 51/58 (88%) of those who had a planned telehealth consultation as part of their management. A median of 634 km of patient travel was saved per telehealth consultation.
Discussion
We found that a telehealth-supported outreach programme for patients in regional Australia with HCV produced similar outcomes to clinical trials. There was a considerable saving in time and cost for the patients and significant environmental benefit through the reduction in carbon footprint associated with travel to distant specialist health services. We conclude that telehealth facilitated outreach is a feasible and effective way to access HCV treatment and cure in regional Australia.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>30336724</pmid><doi>10.1177/1357633X18806651</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult Aged Antiviral Agents - therapeutic use Antiviral drugs Australia Benzimidazoles - therapeutic use Carbamates - therapeutic use Clinical trials Delivery of Health Care - organization & administration Female Fluorenes - therapeutic use Health Services Accessibility Hepatitis Hepatitis C Hepatitis C - drug therapy Humans Imidazoles - therapeutic use Male Middle Aged Patients Pyrrolidines - therapeutic use Retrospective Studies Sofosbuvir - therapeutic use Telemedicine Treatment Outcome Valine - analogs & derivatives Valine - therapeutic use |
title | Using telehealth to improve access to hepatitis C treatment in the direct-acting antiviral therapy era |
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