Beyond the Walls of the Clinic STACEY B. TROOSKIN MD PHD DREXEL UNIVERSITY COLLEGE OF MEDICINE...
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Beyond the Walls of the Clinic STACEY B. TROOSKIN MD PHD DREXEL UNIVERSITY COLLEGE OF MEDICINE PHILADELPHIA, PA
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Transcript of Beyond the Walls of the Clinic STACEY B. TROOSKIN MD PHD DREXEL UNIVERSITY COLLEGE OF MEDICINE...
Beyond the Walls of the ClinicSTACEY B. TROOSKIN MD PHD
DREXEL UNIVERSITY COLLEGE OF MEDICINE
PHILADELPHIA, PA
Viner et al. Hepatology. 2015 Mar;61(3):783-9.
HCV infected (es-timate)
HCV Ab HCV RNA HCV in medical care
HCV antiviral treatment
0
5000
10000
15000
20000
25000
30000
Num
ber o
f Ind
ivid
uals
47%
22%
6% 3% 6%
Philadelphia Cascade of Care 2010-2013
Community based testingA testing and linkage to care campaign that stimulates demand for and provides
HIV and HCV testing across an entire zip code.
Do One Thing Campaign HCV Testing and Linkage to Care Cascade n=1,301
58%
Trooskin S et al. JGIM. 2015 Jul;30(7):950-7.
Lessons Learned from Do One Thing
The HCV care continuum is complex
Multiple barriers exist◦ Referrals◦ Obtaining medication for patients/ payer restrictions
Patient navigation is key when patients are tested via outreach
Outreach testing and community engagement is a way to re-engage individuals living with HCV not currently in care
Immediate blood draw for PCR confirmatory testing is necessary◦ Local hospital labs can partner to process and test specimens on nights and weekends
These informed our design of C A Difference
Clinical Testing Community Testing
Patient Navigation
Subspecialty Care for HCV
0
50
100
150
200
250
223
183
161
10595
41
Num
ber o
f Par
tici
pant
s
Interim C a Difference HCV Testing and Linkage to Care Cascade
These numbers represent an interim analysis and do not reflect individuals recently tested
Integrated Community Based HCV Testing: Lessons Learned
Integrating HCV testing into existing HIV and STI testing programs has advantages◦ Sustainability from diversified funding sources◦ Reaches individuals at greatest risk◦ 2014 tested, anti-HCV seroprevalence 11.07%
Education is required for staff around the importance of immediate confirmatory HCV RNA testing◦ Testers should be trained phlebotomists
Communication is key when community testers do not also act as the patient navigator
Maintaining a low patient navigator to patient ratio is critical (we are in the process of identifying the optimal ratio)
Best Practices in Coalition Building
◦ Philadelphia-area collective dedicated to improving the continuum of hepatitis C prevention, care, and support services in Philadelphia
www.hepcap.org
Thank you! Do One Thing Team
◦ Amy Nunn ScD, Brown University
C a Difference Team◦ Lora Magaldi, MA C a Difference Project Coordinator◦ Carla Coleman, Linkage Coordinator◦ Ta-Wanda Preston, Outreach specialist◦ Students, volunteers, patients
Alex Shirreffs MPH, Government Co-Chair of HepCAP◦ HepCAP members
Gilead Sciences FOCUS
