Case Study
Health advice: Chronic condition treatment
A member with a diagnosis of asymptomatic autoimmune hepatitis sought a second opinion through their health insurer’s member benefits program after discontinuing their prescribed medication due to concerns about potential side effects they had read about online.
The diagnosis had been confirmed through a range of investigations, including a liver biopsy, and the member had initially responded well to treatment. The case was allocated to an independent hepatologist, who reviewed the member’s test results before conducting a telephone consultation to discuss their condition and treatment.
The specialist explained that, without treatment, the member was at significant risk of developing liver cirrhosis within five years, or sooner. This could lead to liver decompensation, an increased risk of infections, internal bleeding, liver cancer, liver failure and, ultimately, death.
As the member was not a suitable candidate for a liver transplant due to their age, the specialist stressed the importance of treating the liver inflammation promptly to preserve liver function and prevent further damage. The specialist also confirmed that the treatment recommended by the member’s treating specialist represented the current gold standard of care for their condition.
Outcome
Following the consultation, the member discussed the independent specialist’s written report with their treating specialist. Together, they made the decision to recommence treatment.