Re-Engagement Of Clients With Hepatitis C Attending A Substance Misuse Service Following An Education Day To Community Psychiatric Nurses (CPNs)

Author: Thomson R, Sinclair A , Dundas P. Adams J, English S NHS Grampian

Theme: Clinical Research Year: 2017

Following the introduction of new treatment regimes in 2015, NHS Grampian’s Hepatology team sought to re-engage Hepatitis C positive patients with specialist services. The team conducted an education day at a Substance Misuse Service (SMS) to empower CPNs to test for Blood Borne Viruses (BBVs) and to re-engage patients with specialist services.

Analysis of a cohort of clients attending SMS. Hospital systems were used to obtain BBV and follow-up status. The education day highlighted newer treatment regimens and identified clients who had been lost to follow up or never attended specialist services.

There were 365 clients registered with SMS during the study period, with an average age of 37 (22-76) and 61% were male. In total, 302 (83%) of the 365 clients having been tested for HCV, 105 (35%) were HCV antibody positive and 313 (86%) had been tested for HBV & HIV.
Of the 105 (35%) HCV antibody positive clients, 58 (55%) were HCV PCR negative, 4 (4%) had an unknown PCR status and 43 (41%) were HCV PCR positive. Prior to the education day, 26 (60%) of those with active infection had been lost to follow-up or never attended specialist services and 17 (40%) were under continued follow-up, which included 4 (9%) of clients on the treatment waiting list. After the education day, 13 (30%) remained lost to follow-up or never attended, 1 client had been discharged following spontaneous viral clearance, the remaining 29 (68%) were under continued follow-up, 14 (33%) of whom were on the waiting list for treatment.

In this cohort of SMS clients, only 63 (17%) clients had never been tested for HCV, which represents a good success rate for BBV testing. Since the education day, 50% of those who were lost to follow-up have been re-engaged with specialist services.

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