SERVICE DEVELOPMENT -NURSE LED MULTIAGENCY HEPATITIS C MOBILE COMMUNITY OUTREACH SCREEN TEST TREAT SERVICE
Gut
; 71:A82-A83, 2022.
Article
in English
| EMBASE | ID: covidwho-2005361
ABSTRACT
Introduction Delivery of the World Health Organisation elimination agenda for Hepatitis C Virus (HCV) requires active case finding, to engage hard to reach risk groups. Surrey is a relatively affluent part of the country, but contains pockets of significant unmet need, which are a barrier to the HCV care cascade. In 2020 the Surrey HCV Operational Delivery Network (ODN) piloted 'pop up clinics' for housed homeless populations during the COVID 19 pandemic. Based on this experience the ODN lead successfully bid for NHS England funding for a Mobile Outreach Van (MOV). Methods Detailed mapping of the ODN was undertaken jointly with the Hepatitis C Trust to identify potential locations to screen e.g., Opiate Substation Therapy dispensing pharmacies, and areas with high numbers of homeless people. MOV procurement and governance obtained in accordance with Trust policy. Individuals complete a brief liver health questionnaire including Blood Bourne Virus (BBV) risk factors. HCV screening is undertaken using Oraquick point of care testing. Those screening HCV Antibody positive (Ab +ve) receive a Clinical Nurse Specialist (CNS) assessment for therapy including a BBV screen HCV PCR and Fibro Scan. Hepatitis C Trust peer support is available to all individuals. Other significant findings prompt onward referral e.g., cirrhosis surveillance. Results First six months of operation the team have undertaken 50 testing days in 16 venues. 761 individuals have accepted HCV Ab screening. 40 (5.2%) tested HCV Ab +ve. 10 individuals confirmed viraemic and eligible for treatment. Another 7 individuals were re-engaged to undertake end of treatment or Sustained Virologic Response 12/48 PCR. In addition, 1 HCV Ab +ve (PCR negative), patient was diagnosed with Human Immunodeficiency Virus and referred to the local sexual health team. 16 individuals identified with advanced fibrosis or cirrhosis were referred to hospital for Hepatocellular Carcinoma surveillance. Patients engaged through the MOV service have received their treatment in the community via this service delivered by a CNS. Conclusions Nurse led MOV screen test treat model has proven to be safe and effective in engaging difficult to reach populations. Hepatitis C Trust peers accessibility help to address the anxiety/stigma surrounding HCV. MOV wider benefits include engagement with drug and alcohol services, and harm reduction. The next phase of implementation, the team plan to deliver needle exchange and naloxone in a partnership agreement with Surrey County Council.
alcohol; naloxone; opiate; virus antibody; adult; advanced cancer; anxiety; cancer patient; cancer surgery; case finding; clinical assessment; clinical nurse specialist; conference abstract; controlled study; coronavirus disease 2019; drug therapy; England; female; fibrosis; funding; harm reduction; hepatitis C; hepatitis C rapid test; Hepatitis C virus; high risk population; homeless person; human; Human immunodeficiency virus; liver cell carcinoma; liver cirrhosis; major clinical study; male; needle; nonhuman; nurse; pandemic; patient referral; peer group; pharmacy (shop); point of care testing; questionnaire; risk factor; sexual health; stigma; sustained virologic response; trust; World Health Organization
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Gut
Year:
2022
Document Type:
Article
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