Hepatitis C Testing in Community Pharmacy Based Needle Exchanges - A Pilot
PHE ePoster Library. Leeman D. Apr 10, 2019; 257483
David Leeman
David Leeman
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Abstract
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Abstract Background:
In the UK people who inject drugs (PWID) account for 90% of all new HCV infections. For those not currently engaging in drug treatment, testing and referral into treatment is sparse. Needle and syringe provision (NSP) in community pharmacies provides a potential point of contact to offer opportunistic HCV testing, education and referral into treatment.
Methods:
Point of care oral fluid antibody tests were provided to nine community pharmacy based NSPs across London from October 2017 to March 2018. PWID accessing NSPs were invited to participate and were tested for HCV, provided with information on HCV and harm reduction. A questionnaire was completed to gather information of knowledge and preference of HCV treatment. Positive results were referred to secondary care services.
Results:
216 tests were conducted and 178 included in the analysis. Ninety five (53%) were positive for HCV antibodies. Forty one of these resulted in people being informed that they were HCV antibody positive for the first time. Eighty five people were referred onto secondary care:27% attended their appointment78% of those were HCV RNA positiveOf these, 33% (6) had end-stage liver disease.Only 70 (43%) participants were aware that current treatment does not require interferon and 84% reported that they would prefer to receive treatment in their pharmacy.ConclusionProviding opportunistic HCV tests within NSP community pharmacies can be an effective tool in identifying and referring PWID with HCV. There does however exist a significant gap between screening and treatment. Phase 2 of this pilot will include RNA testing and phase 3 will move treatment to pharmacies with an aim of closing this gap, increasing treatment rates and supporting more people to achieve a sustained viral response. Funding Funding for pilot including cost of oral fluid kits received from MSD pharmaceutical company
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