The secondary outcome was two-year cirrhosis-related mortality. The study
was approved by the Partners Human Research Committee (protocol 2012P001912). Results: Seventy-eight patients (19.7%) had at least one cirrhosis-related hospital admission within one year. The following were significant predictors in the multivariable model (Table 1): Model for End-Stage Liver Disease (MELD) score > 15, diagnosis of hepatocellular carcinoma (HCC), diuretic use, at least one cirrhosis-related admission during the Temsirolimus baseline year, and being unmarried. Conclusions: Higher MELD score and diuretic use were associated with cirrhosis-related hospital admissions in an ambulatory cirrhosis cohort. Our findings suggest that patients with
inadequately or overzealously treated ascites could benefit from intensified outpatient management aimed at chronic disease management and reducing preventable admissions. Disclosures: James M. Richter – Consulting: Axcan Pharma Raymond T. Chung – Advisory Committees or Review Panels: Idenix; Consulting: Enanta; Grant/Research Support: Gilead, Merck, Mass Biologic, Gilead The following people have nothing to disclose: Kara B. Johnson, Emily J. Campbell, Heng Chi, Hui Zheng, Lindsay Y. King, Ying Wu, Andrew deLemos, Abu NVP-AUY922 purchase Hurairah, Kathleen E. Corey BACKGROUND: The ECHO model allows for the treatment of hepatitis C by primary care providers in remote rural sites with ongoing teleconferencing support. Current therapy, particularly with the addition of protease inhibitors, involves increasingly complex management of response milestones and adverse event management. HCVNET Arizona is a Project ECHO site focused around a 14 site FQHC based in Flagstaff. Because of the rapid growth in patient numbers and treatment sites, it was elected to define specific starting dates at which all patients being readied for treatment would receive their first pegylated interferon injection. This allowed for each patient at each site to obtain their laboratory studies on the same day of the week and have their side
effects managed and their treatment milestones coordinated simultaneously across the treatment network. This approach afforded the opportunity find more to coordinate all associated treatment activities such as pre-treatment work-up, patient training, and medication authorization. METHODS: A total of five cohorts among twelve sites have thus far been initiated at 2 month intervals with an average of 8 patients per cohort. No single clinic site had more than 3 patients starting at any one time. 70% of patients were genotype 1 and received telaprevir-based therapy. The hepatology team at St. Joseph’s Hospital and Medical Center teleconferences with all providers on a weekly basis every Wednesday. Patients generally had complete blood counts and chemistry panels drawn on the prior Mondays. Each patient is then reviewed with the local provider during the teleconference.