TY - JOUR T1 - Primary care flow sheet for hepatitis C virus JF - Canadian Family Physician JO - Can Fam Physician SP - e384 LP - e392 VL - 62 IS - 7 AU - Zoƫ von Aesch AU - Leah S. Steele AU - Hermant Shah Y1 - 2016/07/01 UR - http://www.cfp.ca/content/62/7/e384.abstract N2 - Objective To develop an expert-guided, evidence-based, primary care flow sheet for the monitoring of patients living with chronic untreated hepatitis C virus (HCV).Design Delphi consensus process.Setting Ontario and British Columbia.Participants Five hepatologists and 4 family physicians experienced in HCV care.Main outcome measures There were 3 rounds of consultation and revision. In round 1, participants ranked (on an 11-point scale) the importance of 27 possible clinical elements that fell under the categories of background patient information, counseling topics, and biochemical parameters; indicated the ideal frequency of such interventions (in months); and suggested additional elements. Results were collated and elements that were ranked with an average score greater than 4.9 were included in further iterations. The second and third rounds involved the circulation of draft flow sheets, and participants were asked to flag erroneous or missing elements. All comments were integrated.Results Group consensus was achieved following 3 iterations. The final flow sheet to improve monitoring of HCV in primary care includes 31 clinical elements that fall under the categories background patient information, key counseling topics, and biochemical parameters (and the intervals for such interventions).Conclusion A diverse group of experienced clinicians came to a consensus regarding optimal primary care monitoring and counseling of the untreated HCV population. Future steps include refinement and pilot-testing of this flow sheet in order to optimize its usefulness within the family medicine setting. ER -