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Gastroenterology

Reengagement of HCV patients lost to follow-up needed to achieve WHO goals

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Reengaging patients with Hepatitis C Virus (HCV) who have been lost to follow-up is a feasible endeavor via phone call and mail letter strategies, according to a study.

The World Health Organization has set the goal of eliminating HCV by 2030, which will require reengaging patients lost to follow-up.

The study identified 1167 patients who had tested positive for HCV antibodies but had not undergone subsequent RNA testing between 2005 and 2018. Among them, 345 patients were classified as lost to follow-up and were included in the analysis. These patients were then randomized into 2 groups: a phone call strategy and a letter of invitation strategy, with both groups later switching strategies.

An analysis of the first 270 patients showed that the mail letter strategy achieved a higher contact rate compared to the phone call strategy (84.5% vs 50.3%). However, in terms of appointment attendance, there were no significant differences between the strategies in the intention-to-treat analysis (26.5% vs 28.5%).

When examining efficiency, the study found that it required 3.1 letters and 8 phone calls to successfully connect with one patient (P < 0.001). However, if only the first call attempt was considered, the number of phone calls needed dropped to 2.3 (P = 0.008).

Factors associated with nonattendance at the appointment included prior specialist evaluation and HCV testing in the pre-direct-acting antiviral era.

Reference
Morales-Arraez D, Hernández-Bustabad A, Reygosa Castro C, et al. Reengagement strategies for hepatitis C patients lost to follow-up: A randomized clinical trial. Hepatol Commun. 2023 May 18;7(6):e0080. doi: 10.1097/HC9.0000000000000080. PMID: 37204411.

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