CASE STUDY:

Antiviral Therapy for Hepatitis C

CHALLENGE

Our client had an HCV treatment regimen which was curative, but only with 100% adherence. About 1/3 of patients were not able to complete treatment. The challenging medication routine included two pills and an injection, the need for regular monitoring, and significant side effects. To differentiate their medication in a competitive market, the client wanted a higher rate of patients to complete the full course of treatment and be cured of the disease.

HCS SOLUTION

We delivered an omnichannel support program designed to address patient barriers and increase adherence. In addition to phone support and educational materials, we sent nurse practitioners with experience in HCV treatment to clinicians’ offices to educate patients as they initiated treatment.

IMPACT

Our program increased the percentage of patients completing therapy from 63% to 74%.

A Patient's Experience

MEET ANDREA

Andrea*, a 35-year-old single mother of two who worked in retail, contracted Hepatitis C from sharing a needle. Her clinician prescribed an antiviral pill therapy.

STRUGGLING WITH TREATMENT

Andrea previously had difficulties sticking with an HCV treatment regimen, had trouble dealing with the flu-like side effects of treatment, and associated injecting with her past substance abuse. Andrea was also worried about her finances. She didn’t know if she could afford treatment and was worried about losing her job when the side effects made her too sick to go to work.

ENROLLED IN THE PROGRAM

Knowing that additional support could help Andrea stay on her treatment plan, Andrea’s clinician enrolled her in the Patient Support Program. He used the Patient Counseling Tool, which provided evidence-based talking points to guide their discussion about the importance of taking the medicine as prescribed.

TREATMENT EDUCATORS

As part of the Patient Support Program, Andrea’s clinician invited her to participate in a group training session led by Treatment Educators with experience in HCV treatment. Along with other patients, Andrea learned more about antiviral therapy and how to stay on track with her treatment plan.

WELCOME PHONE CALL

Andrea’s Treatment Experience Nurse called to welcome her to the program and completed a barrier assessment, which was entered in the SmartCARE Platform and reported to Andrea’s clinician through the Clinician Feedback Loop.

Andrea’s Barriers

  • Not understanding that treatment is curative
  • Medication routine and logistics
  • Managing side effects
  • Work and financial concerns

SUPPORT OFFERED

The Treatment Experience Nurse addressed Andrea’s concerns about injecting, suggested tips on how to manage her flu-like side effects, and encouraged her to discuss any side effects with her clinician. She also reinforced the importance of medication adherence to achieve a cure, and helped Andrea establish a routine that would help her manage the timing and food requirements of her medication.

First Call: Barriers addressed

  • Not understanding that treatment is curative
  • Managing side effects
  • Medication routine and logistics

Communication preferences

  • Patient interested in receiving more information by phone and email

Content Delivery: Email

  • “Building a Medication Routine” gave Andrea additional ideas on how to keep track of all the medicines in her HCV regimen

BARRIERS REASSESSED

During their next call, Andrea told the Treatment Experience Nurse that she had been missing work because she was still experiencing side effects. She was worried that she might lose her job.
The Treatment Experience Nurse reviewed additional tips on how to manage side effects and suggested some government assistance programs that might help while Andrea couldn’t work due to her condition.

Second Call: Barriers addressed

  • Managing side effects
  • Work and financial concerns

Content Delivery: Email

  • “The Impact of HCV and Treatment on Work and Finances” provided tips on how to talk to an employer about missing work

MONITORING APPOINTMENT

Andrea went to her follow-up appointment to discuss the results of her recent blood tests with her clinician. She shared the log of symptoms and side effects that she had been recording in her Patient Starter Kit and she used the Appointment Tear Pad from the kit to take notes during the appointment.

ONGOING SUPPORT

During subsequent scheduled calls, the Treatment Experience Nurse continued to monitor Andrea’s progress, reassess her barriers, and update her record for the SmartCARE Platform and Clinician Feedback Loop.

 
A Clinician’s Experience

LIMITED TIME AND RESOURCES

Dr. Moore* didn’t have enough time or resources to provide the amount of support Andrea needed to stay on her treatment plan. He worried she might not complete treatment without additional support.

LACK OF COMMUNICATION WITH PATIENT

Between appointments, Dr. Moore didn’t know if Andrea was taking her medication as prescribed or that she was experiencing side effects.

SOLUTIONS

The Patient Support Program’s Treatment Experience Nurse and Treatment Educators provided additional personalized support that complemented Dr. Moore’s care of his patients. The program also provided tools that helped Dr. Moore improve his communication with patients and monitor their progress between appointments, including the:

  • Patient Starter Kit, which used patient-friendly language and offered tips on how to set expectations and discuss the proper use of the medication
  • Patient Counseling Tool, a step-by-step guide on how to better engage and support patients like Andrea
  • Clinician Feedback Loop, which shared information collected by the Treatment Experience Nurse between appointments, including reported side effects, missed doses and refills, and barriers addressed

MORE SUPPORT, BETTER OUTCOMES

As a result of being enrolled in the Patient Support Program, patients like Andrea were more likely to adhere to their antiviral pill therapy and therefore have better outcomes. Clinicians were able to provide better care for their patients because the program strengthened patient–clinician communication, helped clinicians set expectations for therapy and identify and manage side effects, and provided data between follow-up appointments.

*Illustrative, not an actual patient/clinician

Channels of Support

TREATMENT EXPERIENCE NURSES

Nurses identify and address each patient’s treatment barriers during scheduled outbound calls and are available via a 24/7 hotline to answer questions and offer support

PATIENT STARTER KIT

Provides treatment overview information and tools designed to improve patient adherence

APPOINTMENT TEAR SHEET

Communication roadmap tear pad helpes patients understand and act on
information from appointments

TREATMENT EDUCATORS

20+ licensed clinicians with experience in HCV treatment were available to educate and train patients, clinicians, and mid-level practitioners

SUPPORT MAILERS & EMAILS

Information, tips, activities, and motivational messages are sent to patients throughout treatment based on patient barrier assessments and Treatment Experience Nurse conversations

PATIENT COUNSELING TOOL

Communication roadmap counseling tool helpes remind clinicians of key information to share at each touchpoint

CLINICIAN FEEDBACK LOOP

Reports real-time data on patient status and engagement with the program via a portal, push email, or fax

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