This three-part blog series spotlights the great work of three Community Health Centers addressing Hepatitis C. Hepatitis C is a significant public health problem in the United States. Of the approximately 3.2 million people in the US who have chronic hepatitis C (HCV), most do not know they are infected. HCV is more prevalent in patients who are seen in Community Health Centers than HIV. According to the 2013 Uniform Data System (UDS) 145,309 patients had a primary diagnosis of HCV, up from 61,294 in the prior year. Left untreated, chronic HCV can cause significant liver complications, including cirrhosis, cancer and failure. It is the leading reason for liver transplants in the United States. In this second post on HCV we highlight the importance of patient and community relationships in providing care.
Mary Angerame, MS APRN-BC is a nurse practitioner and head of the Hepatitis C Treatment Program at Jordan Health’s Anthony L. Jordan Health Center in Rochester, New York. Like Caroline Teter from part one of the HCV series, she has hope and is optimistic that new treatment options will increase the number of patients with chronic HCV who are cured, will decrease the pool of virus in the community, and will lead to an eradication of HCV in 10 years. And like Teter, Mary agrees that “it’s all in the relationships”. A key member of the center’s HCV team is a patient she treated for HCV—twice. Now cured and able to draw on his own experiences this team member says it his calling to talk with patients, with the community, and with the staff about HCV.
As Angerame points out, “when you work with patients and provide care that is truly patient centered, you not only see them cured, you also see them move forward in their lives in other ways.” Like the homeless patient who regularly attended the center’s peer support group for patients diagnosed with HCV. Today he is cured and starting college.
To address the complex array of issues associated with diagnosis and treatment, the center’s HCV program provides ongoing counseling, mental health services, chemical dependency services, care coordination, healthcare planning, family services, and support groups. When patients clear the virus, there is celebrating and many happy tears. For some patients, says Mary Angerame, completing treatment may be the first success they have ever experienced.
Relationships at the community level are important, too. The health center provides services at three public housing locations. When the food truck is on site with fresh fruits and vegetables, the center’s HCV program team is on site, too, to provide free HCV screening to both residents and other community members. Free screening is also offered at community health fairs. When offered alongside screenings for hypertension, diabetes, and cholesterol, most patients say yes to an HCV screening test. And if patients decline or are not sure they need to be tested, Mary Angerame and her team remind them that early detection for HCV is in line with early detection for breast cancer, heart disease and everything else. Knowing is power.
For more information and resources on HCV, visit http://www.nachc.com/hepatitisc.cfm.