2017-06-06 16:14:37 UTC

AGA Releases New HCV Care Pathway

June 6, 2017

The AGA Hepatitis C Virus (HCV) Infection Care Pathway provides guidance regarding the best practices for managing U.S.-based patients with HCV.

The pathway encompasses the entire care spectrum of patients with HCV — from outreach and screening, to initial evaluation, antiviral treatment and post-treatment follow-up care.  

Approximately 50 percent of Americans with chronic HCV are unaware of their infection status and far fewer have received curative antiviral therapy. New direct acting antiviral (DAA) treatments offer an unprecedented opportunity to cure the more than 2.7 million individuals in the U.S. affected with HCV. Once HCV infection is recognized, linkage-to-care interventions are important to ensure that patients are afforded access to antiviral treatment. 

By implementing HCV Care Pathway in practice settings, clinicians and health-care systems will be able to provide care that is consistent with evidence-based guidelines and performance measures included in the current CMS PQRS HCV Measures Group. Given the diversity in health-care delivery systems across the world, this pathway may not be generalizable to patients and clinicians outside the U.S.

More detailed information can be found in the full HCV Clinical Pathway.

AGA HCV Care Pathway Webinar

Join Fasiha Kanwal, MD, MSHS, AGAF, Nancy Reau, MD, AGAF, and Lauren Beste, MD, on Thursday, June 29, at 1 p.m. ET for a webinar during which they will review the new care pathway and answer your questions about implementation. Register now.

Summary of HCV Care Pathway

Organization of HCV Care Team
Integrated multidisciplinary care has proven effective in improving HCV treatment and sustained virologic response (SVR). Practices will vary in their HCV caseloads, and thus the capacities of individual practices to dedicate staff to each role will likely vary. The clinical team may include the following team members:

  • Care coordinator —  Main point of contact for the patient throughout all aspects of treatment and care.
  • Clinical pharmacist — Administers pre-treatment assessment for drug interactions, monitors adherence, preventative waste and diversion of expensive medications.
  • HCV specialist — Provides pre-treatment evaluation and prescribes HCV treatment.
  • Mental/substance abuse provider — Addresses high prevalence of behavioral and mental health problems in patients. 

Initial Evaluation of Patients With HCV
The first visit is an opportunity to assess medical conditions that may contribute to progression, risk of complications or potential treatment regimens. Although HCV eradication is considered beneficial in virtually all infected persons, a patient must be physically and mentally ready for treatment. 

Continued patient education and obtaining follow-up data for conditions identified at the first assessment should be the objectives for the second visit. This visit also offers an opportunity to initiate treatment or treatment planning. 

Post-Treatment Monitoring and Follow-up Care
Appropriate follow-up recommendations and ongoing linkage to liver-related care is important for excellent HCV care. Patients who do not achieve SVR after antiviral treatment should continue to receive ongoing monitoring for progressive liver fibrosis. At this point, patients may be referred to an experienced HCV provider, preferably one with access to clinical trials for patients who did not respond to the current DAAs. 

AGA offers an HCV Clinical Service Line that provides tools to help you become more efficient, understand quality standards, and improve the process of care for patients. 


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