Ongoing management of hepatitis C in primary care

Although treatment for hepatitis C is provided by secondary care, primary care physicians can continue to play an important role. It is important to have good communication between primary care and secondary care in order to provide good ongoing management to the patient.

• the patients address and mobile phone number should be confirmed at the time of referral and if necessary in patients who change their address frequently or with insecure postal address or who are homeless, the practice's address can be used
• when the date and the time of the referral appointment is informed to the practice (usually within 4 weeks of receiving a referral - while the person is well-motivated) the primary care should encourage the patient to attend to these appointments

Regular clinical reviews should be arranged and patients should be encouraged to attend to them. During these reviews provide:

• ongoing General Medical Services to support the person through the treatment process
• advice on therapy and how to manage the side effects of treatment e.g. - paracetamol for pyrexia, anti emetics for nausea, moisturizes and steroid creams for itchy skin
• ongoing harm reduction behaviour
  • support about abstinence or reduction of alcohol consumption
  • support regarding drug dependency and if necessary substitution therapy (1)
• monitor mental health especially for depression (1)

Reference:

• 1. Royal College of General Practitioners (RCGP) 2007. Guidance for the prevention, testing, treatment and management of hepatitis C in primary care