Theme: Models of Care Year: 2022
Background:
Historically, Hepatitis C (HCV) care in inner-city Calgary has been delivered though CUPS Liver Clinic,
a multidisciplinary low-barrier agency serving people experiencing poverty, homelessness and
substance use disorders. Although self-referral was encouraged, patients still needed to physically
present to CUPS, which was not necessarily their medical home. As a result, there were many missed
opportunities to screen and treat HCV. Our model of care seeks to increase screening and treatment,
foster collaboration between service providers, and improve continuity of care for transiently
engaged patients.
Description of model of care/intervention:
Our project aims to coordinate the HCV efforts of multiple agencies which provide health care,
shelter, and addictions services in the inner-city. We have formed partnerships with: (1) an inpatient addictions service to arrange HCV treatment for people hospitalized for addictions-related
complications and then transitioned to care through CUPS; (2) an Indigenous Primary Care Clinic to
engage their clients in HCV care within their medical home; (3) the pharmacist at Calgary’s largest
shelter; (4) local addictions and recovery clinics; and (5) patient-supported housing programs.
Effectiveness:
So far we have engaged over 150 shelter clients in screening, completed curative treatment for 18
patients, with ongoing case management in progress for another 25 patients. Since expanding our
network, there is already interest from other in-patient addiction service providers to expand to
more hospital sites. We are hiring peer support workers to improve cultural safety and facilitate
linkage to care, particularly for Indigenous clients. The shelter pharmacist is engaging and treating
patients, including those previously lost to follow-up.
Conclusion and next steps:
Novel models of HCV care are needed to reach priority populations and manage the stressors on the
healthcare systems created by the pandemic. We anticipate that our model will improve health
equity in the inner-city and can be replicated elsewhere.
Disclosure of Interest Statement:
The authors have received funding and honoraria from Gilead, AbbVie, and Coverdale, the Canadian
Undertaking Against Hepatitis C (CanHepC) and the Alberta Pharmacists’ Association (RxA). Other
influential affiliations include Alberta Health Services, University of Calgary, University of Victoria,
and the Sexually Transmitted Bloodborne Infections (STBBI) Hepatitis C Working Group.