Hepatitis C Care In An Opioid Substitution Treatment Unit


Author: Larsson SB, Lundström E, Hansson R, Pizarro E, Lindgren J, Wejstål R, Ydreborg M

Theme: Models of Care Year: 2018

Background:
Among patients in the oral substitution treatment (OST) programme at the addiction unit of
Sahlgrenska University Hospital, 60 % have been infected with hepatitis C virus (HCV).
Despite the geographical proximity to the Clinic of Infectious Diseases only half of the
patients with an active infection attend follow up and are eligible for treatment. To increase
the number of hepatitis C care recipients in this group it is crucial that it is made more
accessible.
Description of intervention:
A nurse from the Clinic of Infectious Diseases visited the OST programme once a week
during six weeks, performing Fibroscan and blood tests. The Fibroscan could be transported
to the addiction unit in the hospital’s culvert. The following week a specialist in Infectious
Diseases met the patients to inform them of the results and treatment options. For
administrative reasons, patients were booked at specific time slots but patients were
received throughout the morning on a drop-in basis when OST was distributed.
Effectiveness:
Twenty patients were eligible for this intervention. After six weeks eighteen patients had been
assessed for hepatitis C and eleven of them are now on treatment or will soon start
treatment.
Conclusion and next steps:
By moving hepatitis C care to an OST programme more patients get access to care and may
receive treatment. Even though visits took place in the OST programme some patients
missed their appointments. Thus it is important to offer several occasions for testing and
follow-up, ideally with a drop-in approach. The next step will be to reach outpatient addiction
clinics outside the hospital grounds.

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