Nurse-led models of care
In collaboration with a medical specialist, appropriately qualified and experienced hepatology nurses are involved in educating, supporting and clinically managing people with liver disease during their treatment journey. Several Australian state governments have already committed significant investment to deliver nurse-led models of care for clinical assessment and management of HCV infection, with clinics staffed by advanced practice nurses or nurse practitioners.9,10 Such models involve supervised practice within well-defined clinical protocols, including education, patient support, clinical assessment, performance of diagnostic tests such as transient elastography, and monitoring of treatment. Nurse-led HCV outreach clinics appear to be a cost-effective way of decentralising care and increasing HCV treatment capacity. They have been used to expand HCV education and treatment into a variety of HCV high-prevalence community settings including prison populations, opioid substitution treatment centres, primary health services for PWID, and remote regions described below.10,11
Nurse practitioners can now prescribe DAAs independently. The PBAC has recently expanded the criteria for prescribing the new DAA treatments through the PBS General Schedule (Section 85) to include authorised nurse practitioners experienced in the treatment of chronic HCV infection. Medicines for the treatment of HCV are listed for prescribing by authorised nurse practitioners under the General Schedule only; they are not listed for prescribing by authorised nurse practitioners under the S100 HSD Program.