Telemedicine: An Evolving Field in Hepatology

Piao, Cindy; Terrault, Norah A.; Sarkar, Souvik

doi:10.1002/hep4.1340

Cited by 25 publications

(40 citation statements)

References 12 publications

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“…Few studies have been published in liver diseases [7]. Telemedicine has been used in HCV treatment and in the evaluation of patients with cirrhosis and hepatocellular carcinoma [11][12][13][14]. Two recent studies showed that telehealth was highly effective in the management of post-transplant patients and in identifying candidates for liver transplantation [15,16].…”

Section: Discussionmentioning

confidence: 99%

Feasibility of telehealth in the management of autoimmune hepatitis before and during the COVID-19 pandemic

Efe

Cem

Batıbay

et al. 2020

Expert Review of Gastroenterology & Hepatology

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Objectives: We aimed to evaluate the feasibility of telehealth in the management of patients with autoimmune hepatitis (AIH). The COVID-19 outbreak during the study period provided an opportunity to evaluate any pandemic influence on how telehealth was perceived by patients and physicians. Methods: We included patients with AIH who were followed in the Harran University hospital, Turkey. Patients were managed by either remote telehealth or standard care. Results: A total of 46 (telehealth, n=19 and standard care, n= 27) patients (40 female) with a median age of 32 (range 17-74) years at diagnosis were included in the study. Until the start of the COVID-19 pandemic, the rates of biochemical remission and relapse after remission were similar in the telehealth and standard care groups (89.5% vs. 89.1% and 15.8% vs. 25.9%, p=ns, for both). The telehealth group maintained remission significantly better than the standard care group (100% vs. 77.3%, p=0.035) during the COVID-19 period. All relapses were due to non-adherence to therapy. Psychiatric problems, pregnancy-related issues and drug side-effects could all be managed remotely by telehealth. Conclusions: In this study, we show for the first time that telehealth is a feasible alternative for managing AIH, both under normal circumstances and during the COVID-19 pandemic. Expert opinion: Autoimmune hepatitis (AIH) requires long-life lifelong immunosuppression and followup for most patients. The use of telehealth may be an alternative way to evaluate these patients remotely. We show for the first time that telehealth is effective and useful in the management of AIH in regular time as well during COVID-19. We hope that our study can extend use of telehealth in the evaluation of patients with other causes of chronic liver disease.

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Section: Discussionmentioning

confidence: 99%

Feasibility of telehealth in the management of autoimmune hepatitis before and during the COVID-19 pandemic

Efe

Cem

Batıbay

et al. 2020

Expert Review of Gastroenterology & Hepatology

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“…To address distance as a barrier to care, VA has prioritized improving access to specialty care via telemedicine. For example, the Specialty Care Access Network‐Extension of Community Healthcare Outcomes (SCAN‐ECHO) has applied telemedicine to hepatitis C treatment and cirrhosis co‐management by specialist and primary care providers, and has expedited treatment of patients with newly diagnosed hepatocellular carcinoma (using a tumor board teleconference) . In addition, programs for management of patients with advanced liver disease should include mechanisms for automated ordering, tracking, and follow‐up of imaging and laboratory tests to decrease the likelihood of process failures inherent in diagnostic testing .…”

Section: Discussionmentioning

confidence: 99%

Effect of travel distance and rurality of residence on initial surveillance for hepatocellular carcinoma in VA primary care patient with cirrhosis

Villalvazo

McDanel

Beste

et al. 2019

Health Services Research

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Objective To determine the relationship between travel distance and surveillance for hepatocellular carcinoma among veterans with cirrhosis. Data Sources Veterans Health Administration (VHA) inpatient and outpatient administrative data were linked to geocoded enrollee files. CMS‐VHA merged data were used to assess receipt of Medicare‐financed non‐VA imaging. Study Design A retrospective cohort of US veterans diagnosed with cirrhosis between 2009 and 2015 was examined. First available abdominal imaging following the diagnosis of cirrhosis was analyzed separately as a function of travel distance to the nearest VA medical center (VAMC) and to the patient's assigned VA primary care provider. Veterans with dual use of Medicare and VA services were also examined for receipt of imaging outside of the VA. Principal Findings Veterans who resided more than 30 miles from the nearest VAMC were less likely to receive any imaging for HCC surveillance. Among dual users, increased travel distance between the patient's residence and nearest VAMC was associated with an increased likelihood of receiving any abdominal imaging at non‐VA facilities. Conclusion Increased travel distance to the nearest VA medical center reduces the likelihood of receiving imaging for HCC surveillance in cirrhotic veterans. Future efforts should focus on reducing geographic barriers to HCC surveillance.

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“…Results showed that ECHO was an effective approach to treating HCV infection in underserved communities. Piao et al [ 89 ] have implemented ECHO to California with improvements in SVR, advocating for such programs to be an essential part of HCV care moving forward.…”

Section: Improving the Cascade Of Carementioning

confidence: 99%

Cascade of care for children and adolescents with chronic hepatitis C

Rogers¹,

Balistreri²

2021

WJG

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Chronic hepatitis C virus (HCV) infection presents a significant global public health burden. In 2015, over 400000 deaths worldwide were attributed to HCV infection. This led the World Health Organization (WHO) in 2016 to set the ambitious goal of eliminating HCV by 2030. Adult-centered guidelines have been established in order to provide direction for healthcare professionals, allowing integration of the newest screening policies and therapeutic strategies into their practices. However, for children and adolescents, HCV is a significant, unrecognized public health problem. HCV infection rates in the United States in women of childbearing age and those who are pregnant have increased in parallel with the rising opioid epidemic. An estimated 29000 women with HCV infection gave birth each year from 2011 to 2014 in the United States, with approximately 1700 of their infants being infected with HCV. Newer HCV-specific therapeutics, namely direct acting antivirals (DAA), has brought a new and highly successful approach to treatment of hepatitis C. Recent studies have confirmed similar levels of effectiveness and safety of DAA therapies in the pediatric population. Thus, an enhanced cascade of care, which should include the population under 18 years of age, can help achieve the WHO goal by focusing on elimination in the youngest populations. This review will present an overview of the natural history, clinical features, and management of HCV in children and adolescents.

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Telemedicine: An Evolving Field in Hepatology

Cited by 25 publications

References 12 publications

Feasibility of telehealth in the management of autoimmune hepatitis before and during the COVID-19 pandemic

Feasibility of telehealth in the management of autoimmune hepatitis before and during the COVID-19 pandemic

Effect of travel distance and rurality of residence on initial surveillance for hepatocellular carcinoma in VA primary care patient with cirrhosis

Cascade of care for children and adolescents with chronic hepatitis C

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