{"id":2090,"date":"2018-10-20T18:40:28","date_gmt":"2018-10-20T16:40:28","guid":{"rendered":"https:\/\/angh.net\/abstracts\/hopital-0-hepatites-cest-possible\/"},"modified":"2018-11-29T00:16:31","modified_gmt":"2018-11-28T23:16:31","slug":"hopital-0-hepatites-cest-possible","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/hopital-0-hepatites-cest-possible\/","title":{"rendered":"H\u00f4pital 0 h\u00e9patites: c\u2019est possible!"},"content":{"rendered":"

2018<\/strong><\/p>\n

Laetitia SALABERT, Hakim BOUCHKIRA, J\u00e9r\u00e9my HERVET, Arnaud HAPPIETTE, Laura LE CLOAREC, Hugues WENGER, Andr\u00e9-Jean REMY.Equipe Mobile H\u00e9patites, Centre Hospitalier de Perpignan.<\/em><\/p>\n

H\u00e9patologie <\/strong>– \u00a02018-04-19 –\u00a0CO –<\/p>\n

________________________________<\/p>\n

Introduction :
\nD\u2019apr\u00e8s les derni\u00e8res estimations disponibles, 74000 patients ayant une h\u00e9patite chronique C sont non d\u00e9pist\u00e9s ou non suivis en France. La question \u00e0 r\u00e9soudre est comment trouver ces patients manquants. Depuis sa cr\u00e9ation en juillet 2013, l\u2019Equipe Mobile H\u00e9patites a pris en charge 504 patients ayant une h\u00e9patite C, dont 83% d\u2019usagers ou d\u2019ex-usagers de drogue. Nous avons fait le constat au quotidien que de tr\u00e8s nombreux \u00ab nouveaux \u00bb patients avaient d\u00e9j\u00e0 \u00e9t\u00e9 hospitalis\u00e9s plusieurs fois dans notre \u00e9tablissement, particuli\u00e8rement aux Urgences, mais jamais pour l\u2019h\u00e9patite C. Sur les 6 premiers mois de 2017, cela repr\u00e9sentait 81% des patients nouvellement pris en charge. Dans la macrocible d\u2019entr\u00e9e r\u00e9alis\u00e9e par l\u2019infirmi(\u00e8)re accueillant le patient, il \u00e9tait not\u00e9 avec constance un ant\u00e9c\u00e9dent d\u2019h\u00e9patite C au m\u00eame titre qu\u2019une appendicectomie ou une fracture du tibia. Certains usagers de drogue \u00e9taient venus jusqu\u2019\u00e0 12 fois dans l\u2019ann\u00e9e \u00e9coul\u00e9e ! Aucune orientation sp\u00e9cialis\u00e9e ne leur \u00e9tait propos\u00e9e une fois la pathologie initiale r\u00e9solue.
\nObjectif : identifier les patients ayant une h\u00e9patite C connue et hospitalis\u00e9s dans un service du Centre Hospitalier.
\nM\u00e9thodologie :
\nune infirmi\u00e8re d\u00e9di\u00e9e h\u00e9patites a effectu\u00e9 des s\u00e9ances d\u2019une heure de formation p\u00f4le par p\u00f4le en commen\u00e7ant par l\u2019encadrement infirmier, puis unit\u00e9 par unit\u00e9 \u00e0 l\u2019occasion des rel\u00e8ves. Elle expliquait les modes de transmission des h\u00e9patites, les facteurs de risque, la prise en charge actuelle, notamment sur le traitement pour tous et l\u2019efficacit\u00e9 des AAD. Un flyer d\u2019information et une affiche rappelant les coordonn\u00e9es de l\u2019infirmi\u00e8re d\u00e9di\u00e9e h\u00e9patites \u00e9taient laiss\u00e9s en salle de soins. Les infirmi\u00e8res \u00e9taient invit\u00e9es \u00e0 appeler un num\u00e9ro d\u00e9di\u00e9 d\u00e8s qu\u2019un patient connu h\u00e9patite B ou C entrait dans le service. R\u00e9sultats : l\u2019infirmi\u00e8re h\u00e9patites a r\u00e9alis\u00e9 en 7 mois des s\u00e9ances de formation dans 15 unit\u00e9s diff\u00e9rentes rassemblant au total 85 infirmi(e)res. Elle a re\u00e7u ensuite 28 appels portant sur 88 patients avec une h\u00e9patite C connue ; 27 patients \u00e9taient usagers ou ex-usagers de drogue ; 15 patients avaient une charge virale n\u00e9gative (54%), spontan\u00e9ment ou apr\u00e8s traitement : 13 patients avaient une charge virale positive, dont 7 ont commenc\u00e9 un traitement dans les 3 mois suivant la prise en charge. Tous les patients ayant ou ayant eu un usage de drogue ont b\u00e9n\u00e9fici\u00e9 d\u2019une s\u00e9ance d\u2019\u00e9ducation \u00e0 la r\u00e9duction des risques. Nous avons observ\u00e9 une mont\u00e9e en charge des appels au fur et \u00e0 mesure du nombre de formations effectu\u00e9es. Des r\u00e9sultats plus d\u00e9taill\u00e9s seront pr\u00e9sent\u00e9s lors du congr\u00e8s.
\nConclusions :
\nla formation de relais infirmiers au sein des diff\u00e9rentes unit\u00e9s d\u2019un centre hospitalier est facile \u00e0 mettre en place et utile pour orienter dans un circuit sp\u00e9cialis\u00e9 des patients VHC non pris en charge auparavant. Cette exp\u00e9rience est transposable \u00e0 d\u2019autres centres hospitaliers et permet de cr\u00e9er une dynamique 0 h\u00e9patites \u00e0 l\u2019ensemble de l\u2019\u00e9tablissement.<\/p>\n[download id=\u00a0\u00bb2185″]\n","protected":false},"excerpt":{"rendered":"

2018 Laetitia SALABERT, Hakim BOUCHKIRA, J\u00e9r\u00e9my HERVET, Arnaud HAPPIETTE, Laura LE CLOAREC, Hugues WENGER, Andr\u00e9-Jean REMY.Equipe Mobile H\u00e9patites, Centre Hospitalier de Perpignan. H\u00e9patologie – \u00a02018-04-19 –\u00a0CO – ________________________________ Introduction : D\u2019apr\u00e8s les derni\u00e8res estimations disponibles, 74000 patients ayant une h\u00e9patite chronique C sont non d\u00e9pist\u00e9s ou non suivis en France. La question \u00e0 r\u00e9soudre est […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[3],"tags":[29],"class_list":["post-2090","post","type-post","status-publish","format-standard","hentry","category-hepatologie","tag-29"],"yoast_head":"\nH\u00f4pital 0 h\u00e9patites: c\u2019est possible! - Abstracts des congr\u00e8s de l'ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/hopital-0-hepatites-cest-possible\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"H\u00f4pital 0 h\u00e9patites: c\u2019est possible! 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