Theme: Models of Care Year: 2022
Background:
Significant numbers of people who inject drugs (PWID), including those receiving opiate substitution
therapy (OST) and/or needle and syringe provision (NSP) have limited engagement with drug
services, without comprehensive care, and poorly informed on injecting related risks.
Many PWID identify as being socially marginalised, experiencing health inequalities and unable
without peer support, to navigate standard hepatitis C (HCV) testing, treatment and care pathways.
This situation became more pronounced during the COVID pandemic as resources and access to
holistic care and specifically harm reduction interventions were restricted.
Description of model of care/intervention:
Identified and informed by PWID experiences, the Hepatitis C Trust peer support project developed
a community pharmacy based HCV testing initiative for those receiving OST and/or NSP. Over five
testing sessions at one community pharmacy, clients were offered peer delivered HCV testing and
support to treatment.
Effectiveness:
The project was attractive to the target community who reported ease of access and engagement in
contrast to previously experienced barriers to testing and treatment, promoting the service to
others in their injecting networks:
170 were screened for HCV antibodies.
75 were tested for HCV
40 RNA -ve (29 previously treated but without SVR, 11 self-cleared)
18 RNA +ve (3 reinfections)
17 results pending.
14 patients have started treatment to date.
Conclusion and next steps:
Pharmacy testing has been a resounding success with majority identified with HCV being supported
to start or about to start treatment. Support is planned for cohort tested with results pending. Peer
support is ongoing including safer injecting guidance to reduce reinfections and pharmacy based
SVR12 and SVR48 testing for those who initiated treatment prior to, and as a result of the testing
project. This pharmacy testing model is now being adopted across pharmacy settings in other areas
to meet the HCV needs of underserved PWID.
Disclosure of Interest Statement:
University Hospitals of Leicester NHS Trust has received funding via the NHS England elimination
agenda through Merck Sharp & Dohme to fund a Hepatitis C Community Liaison Support Officer.
This role works in partnership with the Hepatitis C Trust Peer Coordinator and Peer Support Lead in
delivering the Leicestershire Hepatitis C Operational Delivery Network elimination plan.