Davoud Pourmarzi1, Andrew Smirnov2, Julie Hepworth3, Tony Rahman4,5, Gerrard FitzGerald1, Lisa Hall1,2. 1. School of Public Health and Social Work, Faculty of Health, Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology, Brisbane, Australia. 2. School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia. 3. Mater Research Institute, The University of Queensland, Brisbane, Australia. 4. School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia. 5. Department of Gastroenterology and Hepatology, The Prince Charles Hospital, Brisbane, Australia.
Abstract
BACKGROUND: A key to achieving the goal of hepatitis C virus (HCV) elimination is the provision of its treatment in community settings. This study aimed to identify the important organisational and operational elements of community-based models for treating HCV and their feasibility in the Australian context. METHODS: A Delphi study was conducted with 33 experts from Australia. The questionnaire included 13 elements drawn from the literature. Participants rated each element on a five-point Likert scale for importance and feasibility and suggested additional elements. Consensus was identified when the sum of categories 1 and 2 or 4 and 5 of the five-point Likert scale reached greater than or equal to 70%. RESULTS: Eight elements reached consensus in regard to importance including "Safe and enabling environment," "Training and support for healthcare providers," "Open referral policy," "Linkage with or providing outreach services," "Person-centred approach," "On-site screening and assessment," "Linkage or co-location with harm reduction services," and "Linkage or co-location with drug and alcohol services." At least 65% of participants agreed implementing elements of open referral policy, Training and support for healthcare providers, and Person-centred approach are usually or always/very feasible. For the other five elements, this was agreed to by a range of 15.2%-57.6% of participants. CONCLUSION: Successful community-based models for treating HCV in Australia are dependent on the integration and coordination of care and the support provided for both patients and healthcare providers. Substantial work is required across policy and health service planning to integrate these highly rated elements into Australian primary health care.
BACKGROUND: A key to achieving the goal of hepatitis C virus (HCV) elimination is the provision of its treatment in community settings. This study aimed to identify the important organisational and operational elements of community-based models for treating HCV and their feasibility in the Australian context. METHODS: A Delphi study was conducted with 33 experts from Australia. The questionnaire included 13 elements drawn from the literature. Participants rated each element on a five-point Likert scale for importance and feasibility and suggested additional elements. Consensus was identified when the sum of categories 1 and 2 or 4 and 5 of the five-point Likert scale reached greater than or equal to 70%. RESULTS: Eight elements reached consensus in regard to importance including "Safe and enabling environment," "Training and support for healthcare providers," "Open referral policy," "Linkage with or providing outreach services," "Person-centred approach," "On-site screening and assessment," "Linkage or co-location with harm reduction services," and "Linkage or co-location with drug and alcohol services." At least 65% of participants agreed implementing elements of open referral policy, Training and support for healthcare providers, and Person-centred approach are usually or always/very feasible. For the other five elements, this was agreed to by a range of 15.2%-57.6% of participants. CONCLUSION: Successful community-based models for treating HCV in Australia are dependent on the integration and coordination of care and the support provided for both patients and healthcare providers. Substantial work is required across policy and health service planning to integrate these highly rated elements into Australian primary health care.
Authors: Max Ferguson; Andrea Medley; Katherine Rittenbach; Thomas D Brothers; Carol Strike; Justin Ng; Pamela Leece; Tara Elton-Marshall; Farihah Ali; Diane L Lorenzetti; Jane A Buxton Journal: Harm Reduct J Date: 2022-07-02
Authors: Davoud Pourmarzi; Hayley Thompson; James A Thomas; Lisa Hall; Andrew Smirnov; Gerard FitzGerald; Tony Rahman Journal: BMC Public Health Date: 2019-10-22 Impact factor: 3.295