The GP Liaison Project

The project involves the GPLN working with GPs/NPs and other clinical and practice staff to increase their skills, knowledge and confidence in prescribing hepatitis C treatments.

The aim is to increase the number of people in Western Australia (WA) cured, and provide a sustainable workforce competent, confident and capable of prescribing hepatitis C treatments, and ultimately augment progress in the goal of elimination of hepatitis C from the community.

The next decade will be a crucial period in the public health response to hepatitis C. The rapid development and availability of direct-acting antiviral (DAA) therapy for hepatitis C has brought the potential of considerable momentum to therapeutic reform.  However, the number of people in Australia who are accessing hepatitis C treatments continues to decline. According to the Kirby Institute’s Monitoring hepatitis C treatment uptake in Australia (Issue 9), (The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia, July 2018), the monthly uptake of the therapies first listed on the Pharmaceutical Benefits Scheme in March 2016 has more than halved since peaking around this time.  Even more concerning, Western Australia appears to be trailing even further behind the rest of the country concerning people accessing the hepatitis C treatments.

Historically, General Practitioners (GPs) / Nurse Practitioners (NPs) referred patients with a positive hepatitis C serology for specialist treatment, and as such they were inexperienced in the full screening and management of a patient with hepatitis C.

To address this issue, HepatitisWA successfully applied for funding from the WA Department of Health (DoH) Sexual Health and Blood Borne Virus Program (SHBBVP) to implement a project aimed at supporting GPs/NPs to manage their patients rather than referring them to specialist services.

How Does the Project Work

The DoH collates all positive hepatitis C notifications and associated GP/NP/ primary care practices from which the results have come. The relevant GPs/ GP Practices are then notified of the results and at this time they are informed they will receive contact from HepatitisWA’s GP Liaison Nurse (GPLN) who is available to assist them with information, education and support around prescribing hepatitis C treatments, including pathways for referral. At this time GPs/GP practices are given ten (10) days to opt out from receiving contact.

Links to Useful Resources

A Practical Guide to Prescribing the New Hepatitis C Antiviral Drugs in General Practice: http://www.gesa.org.au/resources/hepatitis-c-treatment/

 

PRACTICE SUPPORT RESOURCES

Excellent ideas for practices in identifying and treating clients with Chronic Hepatitis C

 

INITIATING TESTING

https://www.latrobe.edu.au/__data/assets/pdf_file/0005/972239/Talking-Testing-Hepatitis-C.pdf

 

GUIDELINES FOR TESTING FOR AND TREATING CHRONIC HEP C RESOURCES

GESA Decision-Making in HCV: http://cart.gesa.org.au/membes/files/Resources/Hepatitis C/GP_algorithm_Sep_Oct_edit2018.pdf

ASHM Decision-Making in HCV: https://ashm.org.au/products/product/Decision-Making-in-HCV

Hep C Treatment: https://www.gesa.org.au/resources/hepatitis-c-treatment/

ASHM & Kirby Institute Online consultation:  http://www.reach-c.ashm.org.au/

 

DRUG INTERACTION CHECK – UNIVERSITY OF LIVERPOOL (Specifically for the DAAs)

https://www.hep-druginteractions.org/

 

FIBROSCORE

https://www.hepatitisc.uw.edu/page/clinical-calculators/fib-4

 

APRI CALCULATOR

https://www.hepatitisc.uw.edu/page/clinical-calculators/apri

 

EDUCATION & LEARNING

ASHM: https://www.ashm.org.au/HCV/training/

ECU: https://hepatitis.ecu.edu.au/hepc/index.php

NPS WISE: https://learn.nps.org.au/index.php?redirect=0

RACGP: https://www.racgp.org.au/education/professional-development/online-learning/webinars/hiv-and-hepatitis/curing-hepatitis-c-in-general-practice

Abbvie: HCV educational tool for primary care

 

ARTICLES

Primary Care Providers and Hepatitis C: https://www.ashm.org.au/products/product/978-1-920773-42-7

Hepatitis C your crucial role as a primary health care nurse: https://www.ashm.org.au/products/product/1-921850-24-8

 

MAXIMISING MBS BILLING TO SUPPORT HEPATITIS C CARE

https://nwmphn.org.au/wp-content/uploads/2018/05/HCV-and-CHB-MBS-Billing-Items-18.9.17.pdf

 

RESOURCES

HCV educational tool for primary care: Pre-treatment assessment of patients with Chronic HCV