The PREP-C should always be administered in the form of an interview. It should not be given to the patient to fill out on his/her own.
The PREP-C should only be administered to patients 21 years of age or older.
The PREP-C takes 20-30 minutes to administer for most patients. It may take longer in some cases depending on patient complexity. If it is not possible to complete the entire PREP-C in one sitting, it can be completed over the course of multiple interview sessions.
When you begin an interview on a new patient, you will be able to choose between administering the Full version of Prep-C or an Abbreviated version. The Abbreviated version eliminates questions from the Motivation, Medication, Self-Efficacy, Energy Level, and Cognitive Functioning sections based on patient responses. If you administer the Abbreviated version and later decide you would like to administer the omitted questions you can do so by issuing a New Evaluation for the patient in the Portal and choosing `Full version`.
When you begin an interview on a new patient, you will be asked whether the proposed treatment regimen is 'all-oral', 'interferon-based', or 'unsure'. If you choose 'all-oral' then questions that are pertinent to the use of interferon will automatically be skipped over. If you choose 'interferon-based' or 'unsure' then these questions will be asked.
Each patient you enter PREP-C data on will be assigned a consecutive ID number. You are not permitted to enter any Personal Health Information (PHI) of your patients on this web site. PHI includes the patient’s name, address, birth date, phone number, social security number, and medical record number.
It is your responsibility to keep a record separate from this web site to indicate which of your patients correspond to each ID number on the PREP-C web site. When you print out the PREP-C interview with the ID number, there is a space for you to record the patient’s name and Medical Record Number on the written copy.
On certain questions, a symbol will indicate that you should show the answer scale to the patient during the interview to choose his or her answer.
The entire PREP-C evaluation should be completed before any interventions or referrals are made. However, education about HCV infection and HCV Treatment can be provided during the administration of the Information section and you will be asked to note whether or not you have provided this education to the patient.
If you want to contact any providers or programs the patient is in treatment with, you should obtain the contact information and written consent from the patient to do so.
If there is a question that you prefer not to administer or that the patient refuses to answer you can use the 'Skip' option at bottom of each question to go on to the next question.
You can print your completed PREP-C evaluation and/or save it as an electronic PDF file by clicking 'View Printable Report' in the Scoring Section of the individual PREP-C evaluation.
One of the questions in the Psychiatric Stability section specifically asks the patient about suicidal ideation in the last month. If the patient indicates any suicidal ideation in the last month you will not be able to continue with that section of the interview until you have provided an appropriate risk assessment and intervention. This web site provides resources about addressing suicidal ideation (Suicide Risk Assessment and Safety Planning Resources).
You should not administer the Psychiatric Stability section of the PREP-C interview unless you are equipped to address eventual suicidal ideation elicited by this PREP-C section.
If possible, you should know the specific HCV treatment regimen for which the patient is being worked up and the patient’s genotype, HCV viral load, and stage of liver disease.
The web site will usually automatically provide you with a recommendation for scoring each of the 9 areas of functioning based on the answers entered to the questions in each area (either ‘Satisfactory’ or ‘Could be Improved’).
There may be times when not enough information has been entered for a specific area of functioning for the web site to generate a suggested score. You can then manually enter a score for that area of functioning.
You should however use clinical judgment in scoring each area. The criteria for rating an area as ‘Satisfactory’ may differ by HCV treatment setting. For example, the criteria for a patient who is going to be treated in a Methadone Maintenance Treatment Program with Directly Observed Therapy may differ from that of the patient who will self-inject pegylated interferon and be responsible for taking all medications on his or her own at home.
A rating of Satisfactory in a specific area of functioning suggested by this web site does not provide a guarantee that this is the case. It indicates only that no information has been provided that suggests that this area of functioning is not Satisfactory.
Clinical judgment should be used in accepting the recommendations provided by the web site. You are free to override the recommendations given. If there is any reason to believe that the answers provided by a patient are not accurate, for example due to the patient being purposefully dishonest, the patient being psychotic, the patient being under the influence of recreational drugs or alcohol, or the patient not being able to cognitively process the questions, then the recommendations given by the web site should be disregarded.
The web site provides you with suggestions for immediate interventions, resources, and referrals in the Resources section.
Other than the Medication Adherence section, no area is automatically scored ‘Needs Further Evaluation.’ You can change any automatically generated rating of ‘Satisfactory’ or ‘Could Be Improved’ to ‘Needs Further Evaluation’ and make a referral for this evaluation. You will be asked to type in a reason for changing the scoring.
If a plan is made to improve one or more areas of functioning before starting treatment or to request further evaluation, the PREP-C can be repeated at a later time to assess change in these areas of functioning by clicking on the NEW EVAL button for the patient in the portal.