The prevalence of hepatitis C among prisoners in correctional facilities is about 40 times higher than the general population. Yet, upon entry to prison, only 2% of non-Indigenous prisoners and no Indigenous prisoners had received treatment for hepatitis C.
Conventional antiviral therapies for hepatitis C have previously had aggression and mental health issues as a side effect, contributing to their low use in prisons. However, new hepatitis C treatments are now available that are easier to administer, have fewer side effects and require much less follow up. Treatment with these new medications typically takes 12 weeks only. However, in correctional facilities, this process could take up to one year. This is due to a multitude of factors, such as transportation of prisoners to the Princess Alexandra Hospital’s secure unit for tests and scans, and the involvement of multiple medical and specialist staff are needed to review cases, prescribe treatment, authorise referrals etc.
This study examines a revised model of care, in which Hepatitis C treatment will be made available to all eligible prisoners: A hub and spoke model will connect a specialist hepatology team at the Princess Alexandra Hospital (hub) to selected prison sites in Queensland (spokes) via videoconference. This multidisciplinary telehealth service will be used to assess, prescribe medications, and review progress during the full course of treatment. This also means that prisoners will no longer require transportation to the hospital’s secure unit.
Service activity and cost data along with clinical staff perceptions will be gathered with the aim of summarising this model of care and benefits it may have for staff and prisoners.