Table 1.
System-Level | Provider Level | Patients Level | |
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Screening | Screening high-risk patients (PWID, prisoners, and others) |
Proactive action: patient invitation for screening |
Stopping substance abuse |
Modeling high-risk patient screening according to medical files | Being aware with cultural and linguistic barriers | Keeping appointments | |
Universal screening in countries with high HCV prevalence |
Adherence to screening | ||
Linkage to care | Improving HCV antibody and viral load testing accessibility and availability |
Preparing patients for treatment (laboratory test including antibody and HCV viral load) |
Compliance with preparation before treatment, and laboratory testing |
Availability of the point-of-care/self-testing according to the local needs | Case and resource management at the local level |
Insurance coverage | |
Availability of testing for non-invasive liver disease severity assessment (FIB-4, APRI, Fibrotest, FibroScan) |
Using doctor-to-doctor virtual consultation if available | ||
Decentralization of the patient’s investigation/ patient’s preparation for treatment |
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Treatment | Universal access to treatment | Be convinced treatment is possible, easy, and simple | Paying medical expenses |
Shortening wait time for specialist consultation |
Appropriate education for HCV treatment initiation, in regions where providers are authorized to do so |
Adherence to treatment | |
Using telemedicine throughout all phases | |||
Decentralization of treatment approval and prescriptions | |||
Adding prescribers (internist, family doctors, or pharmacists) according to the local needs |
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Clear healthcare policy/national program/protocols |
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Special consideration for people who inject drugs, refugees, and prisoners |
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Other elements | Education and training of the providers | Increasing knowledge, education Staff familiarity with the process of screening, investigation and treatment |
Continuing follow-up |
Increasing awareness among the population regarding the importance of the screening and treatment |
Using telemedicine when possible |
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Other manpower Nurse navigator |