Health Promotion; A Continuing Role For Peer Support Worker In Drug Health Service Liver Clinic

Background: The availability of new hepatitis C therapies with minimal side-effects and high cure rates has potential to eradicate hepatitis C. However, for some, continued care to optimise liver health will be required. For example: those with cirrhosis, alcoholic fatty liver disease, nonalcoholic fatty liver disease. In drug health service (DHS) settings meeting these client needs may be difficult. The use of peer support workers (PSW’s) has been demonstrated to increase engagement of clients with HCV in these settings. Our first objective was to determine the need for ongoing outreach liver clinics in DHS settings with a PSW. Our second objective was to identify through a literature review if healthy lifestyle promotions run by PSWs were an effective intervention. Methods: During routine interactions in a hepatology outreach clinic, anecdotal observations of overweight/obesity prevalence, median age range, and cirrhosis prevalence were estimated. A literature review of effectiveness of healthy lifestyle promotion interventions and the role of PSWs in increasing involvement of clients in these interventions was conducted. Results: The PSW engaged with at least 5 clients per week. About half of the clients presenting to an outreach liver clinic appeared overweight or obese and median age range was mid-40s to early 50s. It’s estimated that about a quarter had cirrhosis. There is a paucity of literature on effectiveness of lifestyle interventions in DHS settings with PSW. Conclusion: Although new treatments may eradicate much of the burden of hepatitis C there is likely to be a continued need for liver outreach services in DHS providing monitoring and care. The demonstrated effectiveness of PSW in engaging HCV patients in DHS suggests they can be instrumental in engaging clients requiring ongoing cirrhosis monitoring, management and hepatocellular carcinoma (HCC) screening. Additionally they may increase effectiveness of healthy lifestyle interventions. There is a need for studies in this area to determine types of intervention required, according to client needs, and to determine the effectiveness of healthy lifestyle promotions facilitated by PSW. Acknowledgments: Would like to thank Judy Pearson and Elizabeth Haines (DHS) for their support

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