Table 2.
Comparison of linkage to care, treatment uptake, and cure assessment in direct-acting antiviral regimen studies with or without comparative groups, according to population group and level of decentralisation
|
Linkage to care, % (95% CI) |
Treatment uptake, % (95% CI) |
Cure assessment, % (95% CI) |
||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Full decentralisation | Partial decentralisation | No decentralisation | p value | Full decentralisation | Partial decentralisation | No decentralisation | p value | Full decentralisation | Partial decentralisation | No decentralisation | p value | |||
| People who inject drugs | ||||||||||||||
| Full decentralisation vs none | ||||||||||||||
| Comparative | 88% (77–94) | .. | 67% (54–78) | 0·008 | 88% (65–100) | .. | 33% (25–43) | <0·001 | 47% (31–64) | .. | 69% (44–86) | 0·130 | ||
| Wade et al (2018), RCT | 88% (77–94) | .. | 67% (54–78) | .. | 74% (60–85) | .. | 39% (26–53) | .. | 47% (31–64) | .. | 69% (44–86) | .. | ||
| Middleton et al (2018), RCS | .. | .. | .. | .. | 98% (88–100) | .. | 27% (17–41) | .. | .. | .. | .. | .. | ||
| Non-comparative | 73% (56–87) | .. | 26% (13–44) | <0·001 | 71% (62–79) | .. | 56% (21–86) | 0·381 | 83% (76–90) | .. | 100% (98–100) | <0·001 | ||
| Number of studies | 12 | .. | 1 | .. | 21 | .. | 1 | .. | 28 | .. | 2 | .. | ||
| Full vs partial decentralisation | ||||||||||||||
| Comparative | 39% (35–44) | 26% (22–30) | .. | <0·001 | 72% (32–98) | 83% (10–100) | .. | 0·954 | 96% (91–99) | 95% (87–98) | .. | 0·697 | ||
| Radley et al (2018), RCT | 39% (35–44) | 26% (22–30) | .. | .. | 52% (45–59) | 44% (36–53) | .. | .. | 96% (91–99) | 95% (87–98) | .. | .. | ||
| Alavi et al (2018), PCS | .. | .. | .. | .. | 88% (77–95) | 100% (91–100) | .. | .. | .. | .. | .. | .. | ||
| Cooper et al (2017), RCS | .. | .. | .. | .. | .. | .. | .. | .. | .. | .. | .. | .. | ||
| McClure et al (2017), PCS | .. | .. | .. | .. | .. | .. | .. | .. | .. | .. | .. | .. | ||
| Non-comparative | 73% (56–87) | 55% (39–70) | .. | 0·108 | 71% (62–79) | 64% (53–74) | .. | 0·310 | 83% (76–90) | 85% (73–94) | .. | 0·756 | ||
| Number of studies | 12 | 15 | .. | .. | 21 | 10 | .. | .. | 28 | 4 | .. | .. | ||
| General population | ||||||||||||||
| Full vs partial decentralisation | ||||||||||||||
| Comparative | .. | .. | .. | .. | 63% (47–77) | 52% (48–57) | .. | 0·146 | 78% (73–82) | 70% (50–86) | .. | 0·826 | ||
| Cooper et al (2017), RCS | .. | .. | .. | .. | 63% (47–77) | 52% (48–57) | .. | .. | 78% (73–82) | 70% (50–86) | .. | .. | ||
| Non-comparative | .. | .. | .. | .. | 71% (62–79) | 64% (53–74) | .. | 0·310 | 86% (79–92) | 89% (47–100) | .. | 0·829 | ||
| Number of studies | .. | .. | .. | .. | 4 | 4 | .. | .. | 10 | 4 | .. | .. | ||
A full list of studies is provided in the appendix (pp 2–25). p values for comparative studies were from pairwise meta-analyses of dichotomous outcomes. p values for non-comparative studies were from two-sample z-tests comparing the results of meta-analyses for proportions using double arcsin transformations. RCT=randomised controlled trial. RCS=retrospective comparative study. PCS=prospective comparative study.