Observational studyJournal of clinical gastroenterology2021
Low Uptake of Direct-acting Antiviral Therapy Among Hepatitis C Patients With Advanced Liver Disease and Access to Care, 2014-2017.
Observational study in Journal of clinical gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed.
- Association between claims-based setting of diagnosis and treatment initiation among Medicare patients with hepatitis C.Health services research · 2024Article
- Reliving it All Over Again: Uncanny Temporalities of Injection Drug Use and Hepatitis C Diagnosis in Southwest Virginia, USA.Medical anthropology · 2023Article
- Loss to Follow-Up and Health Care Utilization After Initial Diagnosis of Eosinophilic Esophagitis.Digestive diseases and sciences · 2022Article
- Evaluation of the hepatitis C cascade of care among people living with HIV in New South Wales, Australia: A data linkage study.Journal of viral hepatitis · 2022Article
- Hepatitis C Virus Is Associated With Increased Mortality Among Incarcerated Hospitalized Persons in Massachusetts.Open forum infectious diseases · 2021Article
- Decreases in Hepatitis C Testing and Treatment During the COVID-19 Pandemic.American journal of preventive medicine · 2021Article
- Expanding access to hepatitis C treatment by improving linkage to care: Establishing a cascade of care and active linkage program for the South Karelia region in Finland.Health science reports · 2020Article
- Diagnostic performance of APRI and FIB-4 for confirming cirrhosis in Indonesian HIV/HCV co-infected patients.BMC infectious diseases · 2020Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
goalsTo determine the proportion and characteristics of adults with hepatitis C at health care organizations in 4 US states who initiated direct-acting antivirals (DAAs).
backgroundThere are almost no data to assess the penetrance of treatment of the hepatitis C population in general US health care settings. STUDY: We conducted a prospective observational study using electronic clinical, pharmacy, and mortality data to determine the fraction of patients who initiated DAAs between January 2014 and December 2017, by start date and regimen. We used stepwise multivariate logistic regression analysis to identify sociodemographic and clinical characteristics associated with receipt of DAAs.
resultsOf 8823 patients, 2887 (32.7%) received DAAs. Quarterly (Q) uptake ranged from 1.1% in Q3 2014 to a high of 5.6% in Q2 2015. Characteristics associated with receipt of DAAs included age 51 to 70 years, higher income, pre-2014 treatment failure, and higher noninvasive fibrosis score (FIB4); however, over one half of patients with FIB4 scores >3.25, consistent with severe liver disease, were not treated. A lower likelihood of initiation was associated with Medicaid coverage. Of 5936 patients who did not initiate treatment, 911 (15.3%) had died and 2774 (46.7%) had not had a clinical encounter in ≥12 months by the end of the study. Fewer than 1% of DAA prescriptions originated from nonspecialty providers.
conclusionsDuring 4 calendar years of follow-up, one third of patients initiated DAAs. Large fractions of untreated patients had advanced liver disease, died, or were lost to follow-up. Even among patients in integrated health care systems, receipt of DAAs was limited.
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