“You don’t want to be waiting. just get on with it”: experiences of hepatitis C point of care testing and same-day treatment

Author: Douglass CH, Vella-Horne D, Elsum I, Allardice K, Guzman R, Heath K, Higgs P, Hellard M, Wade A, Bryant M, Walsh L, Lancaster K, Rhodes T, Moullin J, Stoove M, Doyle J, Pedrana A

Theme: Epidemiology & Public Health Research Year: 2024

Background: Accessing hepatitis C virus (HCV) treatment involves multiple steps. Advances in point of care (POC) testing means it is possible to diagnose HCV and access treatment in a single visit. However, few studies have investigated this model. We explored people’s experiences with POC testing and same-day treatment.

Methods: We conducted a qualitative sub-study within QuickStart, a randomised trial in Australian primary healthcare clinics. QuickStart compared three arms: Arm A (POC antibody testing and standard care), Arm B (POC antibody testing, POC RNA testing and standard care) and Arm C (offering same-day treatment following a positive POC antibody result). We interviewed 17 participants about their experiences with the interventions. Analysis was informed by the Capabilities, Opportunities and Motivations model for Behaviour change.

Results: Capabilities: Compared to venipuncture, most participants found POC testing quick and easy. Some Arm B participants felt that waiting >60 minutes for a POC RNA result was too long given they had busy lives and family responsibilities. Opportunities: Across intervention arms, participants valued support from a friendly and non-judgmental study nurse. For Arm C participants, provision of free medication on the same day made commencing HCV treatment an easier choice. However, some Arm C participants preferred to wait for confirmation of their HCV status from venipuncture to avoid starting medication they may not need and experiencing potential side effects like tiredness. Motivation: Across study arms, participants were motivated to take part in QuickStart to improve their health and ensure they were around for their families in the future. Financial incentives ($40 for a POC test and $80 for a 12-week follow-up visit after treatment) were perceived as an added bonus.

Conclusion: POC testing and same-day treatment addressed some barriers to accessing HCV care. Other important factors included non-judgmental nurses, an opportunity to improve health and financial incentives.

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