Supplementing hard to reach health services in Oslo – A mobile outreach model

Author: Maria Helseth Greve, Gunnar Simonsen Thingnes

Theme: Models of Care Year: 2023

People who inject drugs (PWID) live about 15 years shorter than the rest of the population. This gap in life expectancy would not be accepted in any other patient group. A good number of the earlier deaths are due to known diseases that other patient groups get successful treatment for. Conditions that affect circulatory and respiratory organs, soft tissue infections and kidney disease are all health issues with known cures. One important obstacle to closing this gap is to organize health services in a way that is accessible to this group of patients.

Description of model of care/intervention:
Nurses on wheels (NOW) is a well-established mobile outreach health and harm reduction service in Oslo. We provide services to the most marginalized PWID in Oslo. Our users have reported a high level of trust in the service in yearly user surveys. Trust and outreach can be crucial to reach patients with unresolved health issues. NOW meets patients on the street of Oslo and in private or institutional homes.

Our total inquiries have increased by 54% from n=3951 in 2021 to n=6094 in 2022. Out of these health inquiries have increased by 95% from n=519 in 2021 to n=1011 in 2022. Since 2019 we have performed HCV RNA testing on 238 individuals.

Conclusion and next steps:
Increasing inquiries suggests that this model is key to reach marginalized PWID. Because NOW meet PWID in an outreach setting they are likely to meet patients who are not aware of health issues or do not prioritize visits to health services. Collaboration with public health services ensures specialized follow up when needed. NOW makes use of trusting relationships and a flexible outreach model to contribute to medical progress. Next steps include collaborations on specific health issues by the same model as our HCV project.

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