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- Title
Distance to treatment as a factor for loss to follow up of hepatitis C patients in North East England.
- Authors
Simpson, H; Manley, P; Lawler, J; Morey, S; Buchanan, E; Hewett, M; Knowles, J; Miller, C; McCarron, B; Valappil, M; McPherson, S
- Abstract
Background A large proportion of the 200 000 HCV-infected individuals in the UK are undiagnosed or lost to follow-up. Engaging known infected individuals in treatment is essential for elimination. Methods Using PHE surveillance data and HCV treatment registers from North East of England (NE) treatment centres for 1997–2016, we estimated the number of HCV cases not linked to treatment and the proportion with active infection. We compared distances of treated and untreated cases to treatment services, and assessed the effect of expanding HCV treatment into existing drug and alcohol treatment centres in the NEE on treatment accessibility. Results The odds of being treated was associated with distance to treatment services. Confirmatory results for ~50% were not reported to PHE NE. Overall, 3385 patients reported to PHE NE had no record of treatment; we estimated 1621 of these may have been lost to follow-up after confirmation of active infection. Conclusions Poor access to healthcare services may contribute to under-diagnosis or loss to follow-up. Expanding HCV treatment delivery into NEE drug and alcohol treatment centres would improve the accessibility of treatment services to people infected with/at risk of HCV. This may increase the proportion receiving treatment and support progress towards elimination.
- Subjects
ENGLAND; HEPATITIS C prevention; HEPATITIS C treatment; SUBSTANCE abuse treatment; CHI-squared test; COMMUNITY health services; COMPARATIVE studies; REPORTING of diseases; FISHER exact test; HEALTH services accessibility; PATIENT aftercare; INFECTION; INTEGRATED health care delivery; MEDICAL records; NATIONAL health services; PUBLIC health surveillance; TRAVEL; EVALUATION of human services programs; DATA analysis software; DESCRIPTIVE statistics; ACQUISITION of data methodology
- Publication
Journal of Public Health, 2019, Vol 41, Issue 4, p700
- ISSN
1741-3842
- Publication type
Article
- DOI
10.1093/pubmed/fdy190