Impact of a clinical nurse specialist on the treatment of chronic hepatitis C.

摘要

Hepatitis C virus is a common cause of liver disease and a major health problem worldwide. Modern treatment strategies can be successful in up to 50% of cases, with patients treated in specialist and more general hospital settings. Guidelines issued by the Department of Health and the then National Institute for Health and Clinical Excellence made it obligatory for a clinical nurse specialist (CNS) to be involved with assessing and treating patients with chronic hepatitis C. The aim of this retrospective case study was to assess the impact on referral, assessment and treatment of patients with chronic hepatitis C before and after the introduction of a CNS to Salisbury District Hospital. There was a significant improvement in patient follow-up and intention to treat, with a doubling in treatment rates. This was achieved by improving clinic attendance after the patient's initial outpatient assessment, allowing improved biopsy rates and subsequent selection for antiviral therapy. However, over half the cases with chronic hepatitis C identified in primary care each year were not referred to secondary care for assessment.