PTH-087 Improving hepatitis C detection and treatment via community-based services

Abstract

apportioned telephone review to discuss Results and/or symptoms. As per NICE guidance annual Fibroscan was organised through a dedicated clinic. If any clinical and/or biochemical concerns arose a face-to-face review in clinic is arranged. Results Over this period 45 patients received 6-monthly virtual HBV clinic review. Bloods showed a median peak ALT 36 u/L (0-41 u/L), median viral load 62 iu/ml. and median AFP 2.7. Only 3/45 required face-to-face follow up due to a possible flare, with 2/45 eventually requiring an antiviral agent (Tenofovir). No patients required admission and/or access to other acute and/or community services due to their liver disease during this period. The cost savings were considerable. 6 monthly reviews in a face-to-face clinic over the 2.5 year period would have cost an estimated £27 636. The cost of running a virtual telephone clinic for the same period was £5,517; a saving of 501%. There were only 5 missed blood tests ahead of the clinic appointment. This compares to the 22% DNA rate in our general hepatology clinics. Conclusions A nurse-led virtual clinic provides high-quality, cost-effective care to patients and improves HBV monitoring. Better compliance allows for detection of flares which could require antiviral treatment. With the prospect of new treatments on the horizon it is important these patients remain under the care of a hepatology team and a virtual clinic model allows them to remain engaged with Liver services.