Theme: Models of Care Year: 2018
Background:
Enhancing access and targeting the specific needs of injecting drug users and their networks
requires a flexible approach. Peer Based Harm Reduction WA (PBHRWA) utilizes a unique
model in which a nurse practitioner collaborates with experienced peer-workers to provide
care in a health clinic setting or in the consumer’s home to reduce consumer barriers.
Description of model of care/intervention:
A peer-worker is the first point of contact via interactions at PBHRWA needle and syringe
exchange (NSEP) or during outreach NSEP delivery. The perception of discrimination and
fear of stigma act as significant barriers to accessing health services. This first intervention is
of vital importance, providing a unique level of consumer engagement and trust in the
service.
The second component of the model involves care provided by the nurse practitioner, who
utilises a one-stop-shop model, which greatly eases engagement and increases retention in
treatment. The peer-worker provides ongoing support for consumers; facilitating the
treatment process, assisting them to attend appointments, and addressing other issues and
complex needs.
Effectiveness:
Forty-seven consumers have undergone HCV treatment. Ninety-six percent of the IntentionTo-Treat population have achieved a Sustained Viral Response (SVR). Five consumers
instigated treatment in a non-traditional setting. Of the forty-five consumers who attended the
SVR visit, all achieved a sustained viral clearance. A focus group of ten of these consumers
reported that attending a peer-based organisation increased their confidence and willingness
to enter treatment and made them feel safe from judgement.
Conclusion and next steps:
Integrating services via a peer-based organisation that has well-established and trusted
access to injecting drug users and their networks is a uniquely effective way to reduce
barriers to HCV treatment and provides a highly cost-effective alternative to traditional health
models.
Disclosure of Interest Statement:
Leanne Myers has the following disclosures of interest to declare:
• MSD – Advisory Board 2017 – payment received
• Abbvie – Advisory Board 2017 – payment received