Theme: Models of Care Year: 2025
| Background: To achieve the World Health Organisation’s (WHO) elimination goal for viral hepatitis and HIV, testing needs to be accessible, the Gwent Drug and alcohol service (GDAS) is a third sector organisation that engages with hard-to reach clients (~2000) most at risk for blood borne viruses (BBV) (including Hepatitis C (HCV)). HCV has a high prevalence here and patients were previously tested using Dried Blood spot tests (DBST’s) and Venepuncture. Point of care testing (POCT) is a more acceptable testing method for service users, providing rapid results suiting the turnaround time of clients’ care duration to GDAS. GDAS wanted to implement a two-tiered POCT pathway within their organisation. Methods: One staff member within the GDAS team and an NHS BBV nurse were trained to perform POCT by the Public Health Wales National POCT team. The strategy utilised Orasure OraQuick POCT swabs, screening for HCV antibodies with follow up PCR tests being performed on the Cepheid GeneXpert to detect active HCV infection, DBST’s are used to test for HCV, HBV, HIV and Syphilis. Results: GDAS completed 138 POCT tests with 37 PCR’s over 23 days, 6 active infections have been identified and 5 have been treated, all achieving SVR 12. GDAS now continuously use POCT and the key positive is that people can be treated within three days whereas previous examples could take up to twelve weeks. Conclusion: This new model of care has also been taken up with another organisation in the Cardiff Health Board and we would like to expand further. Outcomes of service implementation and evidence of clinical effectiveness resulted in the purchasing of a second Cepheid device and an additional staff member to expand testing within the region. It’s a clinically effective pathway and model of care for expansion across Wales and for further use on a global scale. |