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The ECHO model proved to be a useful tool to increase clinicians' self‐effectiveness for care of patients with Hepatitis C in Argentina
Author(s) -
Mendizabal Manuel,
Ridruejo Ezequiel,
Ceballos Susana,
Sixto Marcela,
Billordo Ariel,
Gadea Claudia,
Mengarelli Silvia,
Alonso Cristina,
Palazzo Ana,
De María Luis,
Bruno Andrés,
Perez Daniela,
Piñero Federico,
Deltrozzo Verónica,
Mendoza Carlos,
Figueroa Sebastián,
Manero Estela,
Villa Marina,
Barreyro Fernando,
Moreno Valeria,
Vilar José,
Murga Dolores,
Fernandez Marcelo,
O´Flaherty Martin,
Arora Sanjeev,
Silva Marcelo
Publication year - 2019
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.13172
Subject(s) - medicine , echo (communications protocol) , cohort , hepatitis c virus , hepatitis c , competence (human resources) , prospective cohort study , point of care ultrasound , family medicine , emergency medicine , ultrasound , immunology , virus , radiology , psychology , computer network , social psychology , computer science
The ECHO model was developed to expand access to medical care for populations with HCV infection in underserved areas. We aimed to compare HCV treatment outcomes in community‐based clinics with the Austral University Hospital (AUH) and to assess improvement in physician knowledge and skills. In October 2015, we established an HCV ECHO clinic at the AUH in Buenos Aires. To evaluate the impact of this programme, we conducted a prospective cohort study comparing treatment for HCV infection at the AUH with healthcare providers from different Argentinean provinces. A survey evaluating skills and competence in HCV care was administered, and results were compared. The primary endpoint was sustained virologic response (SVR) and under direct‐acting antivirals. Since the implementation of ECHO clinics, a total of 25 physicians participated in at least one session (median 10.0; IQR 3.0‐18.0). SVR rates (n = 437 patients) were 94.2% (95% CI 90.4‐96.8) in patients treated at AUH clinic (n = 227/242) and 96.4% (95% CI 92.7‐98.5) in those treated at ECHO sites (n = 188/195), with a nonsignificant difference between sites, 2.2% SVR difference (95% CI −0.24‐0.06; P = 0.4). We also found a significant improvement in all the evaluated skills and abilities. Replicating the ECHO model helped to improve participants' skills in the management of HCV achieving similar SVR rates. ECHO model was demonstrated to be an effective intervention able to multiply and expand HCV treatment, a critical barrier to access to care that needs to be solved if we are committed with WHO goals to eliminate HCV by 2030.