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Original article
Telementoring with project ECHO: a pilot study in Europe
  1. Clíona Ní Cheallaigh1,2,
  2. Aisling O’Leary3,4,
  3. Shay Keating1,5,
  4. Aileen Singleton5,
  5. Sheila Heffernan5,
  6. Eamon Keenan5,
  7. Lisa Robson6,
  8. Jess Sears7,
  9. John Moloney8,
  10. Sanjeev Arora9,
  11. Colm Bergin1,2,
  12. Suzanne Norris1,2,
  13. On behalf of the Irish Hepatitis C Outcomes Research Network
  1. 1 Department of Genito-urinary Medicine and Infectious, St James’s Hospital, Dublin, Ireland
  2. 2 Department of Hepatology, Trinity College, Dublin, Ireland
  3. 3 National Centre for Pharmacoeconomics, Dublin, Ireland
  4. 4 Royal College of Surgeons, Dublin, Ireland
  5. 5 National Drug Treatment Centre, Dublin, Ireland
  6. 6 South-East Drug Treatment Programme, Waterford, Ireland
  7. 7 De Paul Ireland, Dublin, Ireland
  8. 8 Dun Laoghaire Drug Treatment Centre, Dublin, Ireland
  9. 9 University of New Mexico, ECHO Institute, Albuquerque, New Mexico, USA
  1. Correspondence to Dr Clíona Ní Cheallaigh, St James’s Hospital, Dublin 8, D08 NHY1, Ireland; nicheacm{at}tcd.ie

Abstract

The Extension of Community Healthcare Outcomes (ECHO) project is a novel educational intervention designed in New Mexico to transfer subspecialty knowledge about hepatitis C virus (HCV) to primary care providers, thereby increasing patient access to HCV care. The ECHO model has been shown to deliver educational benefits and to result in good treatment outcomes for HCV-infected individuals in the USA; however, this approach has not been assessed in a European setting.

We sought to evaluate the feasibility, acceptability and implementation of the ECHO model in Ireland using a pilot study. We present a descriptive review of recruitment, participation, retention and cost of the intervention as well as a qualitative review of the views of participants on the barriers, benefits and acceptability of the ECHO model. In the original Project ECHO in New Mexico, geographical distance posed the greatest barrier to accessing HCV care. In Ireland, people who inject drugs (PWID) were identified by interviewees as the main group facing barriers to accessing specialist HCV care. State-employed doctors and nurses caring for large numbers of HCV-infected PWID in opiate substitution treatment centres and homeless hostels were successfully recruited to participate in the project. Self-employed general practitioners did not participate, due mainly to a lack of time and the absence of reimbursement for participation. Practitioners who participated in the pilot reported benefits to themselves and their patients and would like to continue to participate in similar multidisciplinary, multisite educational interventions in the future.

  • telementoring
  • hepatitis C
  • health equity
  • echo

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors CNC designed data collection tools, implemented the programme, monitored data collection, designed the data analysis plan, cleaned and analysed the data and drafted and revised the paper. She is guarantor. AOL initiated the collaborative project, designed data collection tools, monitored data collection for the whole trial, designed the data analysis plan and revised the paper. SK, AS, SH, EK, LR, JS and JM contributed to study design and revised the paper. SA is the originator of the concept underlying the project and contributed to data analysis and revised the paper. CB and SN initiated the collaborative project,implemented the programme, supervised data collection and analysis, and revised the paper.

  • Funding This study was funded by a non-restricted educational grant from AbbVie, and was supported by the HRB and Wellcome Trust-funded Clinical Research Facility in St James’s Hospital.

  • Competing interests None declared.

  • Ethics approval Ethics Committee of the Trinity College School of Medicine.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Transcripts of participant interviews are available on request from the corresponding author.