For the majority of people who have hepatitis C the condition is chronic. Clinical management pathways for people with hepatitis C provide medical practitioners, including general practitioners and consultant specialists, hepatology nurses, community support services, and people who have hepatitis C with best practice guidelines for clinical care. The current model of care document60 does not reflect current evidence or best practice.
However, it continues to be used by health professionals and results in outdated service delivery. An updated model of care should include testing for hepatocellular carcinoma in advanced liver disease and advice on the testing, management and treatment of hepatitis C in the paediatric setting.
Rates of referral from primary healthcare services to specialist hepatitis C treatment and care services remain low. This suggests a lack of clarity around preferred referral practices and a lack of service options for those most affected by hepatitis C. In the era of improved antiviral treatment, availability of and referral to appropriate clinical services is critical. The participation and support of primary healthcare providers in managing hepatitis C remains low and needs to be encouraged to increase the availability of treatment and care.
Hepatitis C treatment and care provision varies across custodial settings in Australia. However, through custodial settings people at high risk of infection can gain access to education, diagnosis and treatment, as well as screening for other BBVs. The Hepatitis C Prevention, Treatment and Care: Guidelines for Australian Custodial Settings (Ministerial Advisory Committee on AIDS, Sexual Health and Hepatitis Hepatitis C Subcommittee 2008) outlines appropriate models of care for people with hepatitis C in custodial settings, although the guidelines have not been implemented.
Priority actions in models of care and clinical management
- Review and revise the Model of care for the management of adults with chronic hepatitis C (2003) regularly to ensure that it stays in step with clinical advancement and changes to management standards.
- Monitor implementation of the Hepatitis C Prevention, Treatment and Care: Guidelines for Australian Custodial Settings.
- Support general practitioners, nurses and other primary care providers to improve their skills in hepatitis C management, treatment and referral.
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60 Australian National Committee for HIV, Hepatitis C and Related Diseases, Model of Care for People with Hepatitis C. 2003.