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A quasi-experimental evaluation of dried blood spot testing through community pharmacies in the Tayside region of Scotland
  1. Andrew Radley1,
  2. Karen Melville2,
  3. Jan Tait3,
  4. Brian Stephens3,
  5. Josie M M Evans4,
  6. John F Dillon5
  1. 1NHS Tayside, Directorate of Public Health, Kings Cross Hospital, Dundee, UK
  2. 2NHS Tayside, Tayside Substance Misuse Services, Dundee, UK
  3. 3NHS Tayside, Gastroenterology Department, Ninewells Hospital and Medical School, Dundee, UK
  4. 4Division of Health Sciences and Sport, University of Stirling, Stirling, UK
  5. 5Division of Cardiovascular Medicines and Diabetes, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
  1. Correspondence to Andrew Radley, NHS Tayside, Directorate of Public Health, Kings Cross Hospital, Clepington Road, Dundee DD3 8EA; 425681, UK; Andrew.Radley{at}nhs.net

Abstract

Objective Comparison of uptake of dried blood spot testing (DBST) for hepatitis C virus (HCV) infection between community pharmacies and established services.

Design Quantitative evaluation of a service development with qualitative process evaluation undertaken in parallel.

Setting Six pharmacies from 36 community pharmacies within Dundee City, a large urban settlement with high levels of socioeconomic deprivation.

Participants Patients in receipt of opioid substitution therapy (OST) not tested for HCV within 12 months. The 6 pharmacies provided OST for approximately 363 patients from a cohort of 1385 patients within Dundee City.

Intervention Provision of DBST by pharmacists.

Main outcome measure Receipt of DBST between January and December 2014.

Results 43 of 143 service users with no record of testing from the 6 community pharmacies accepted DBST. Of 561 from the remaining 1022 service users with no record of testing, 75 were tested for HCV (30% vs 13%). The OR for increased uptake of testing within the 6 pharmacies was 2.25 (95% CI 1.48 to 3.41, Z statistic=3.81, p=<0.0001) compared with other services. The DBST taken by the pharmacies provided 12 patients with a reactive test. The process evaluation identified key themes important to staff and recipients of the service. A logic model was constructed.

Limitations Non-experimental service evaluation performed in community pharmacies records service activity in one location across a single time period.

Interpretation Some evidence that DBST from community pharmacies may be feasible. Service users received the service positively. Staff reported that DBST was straightforward and achievable.

  • HEPATITIS C
  • PRIMARY CARE
  • ANTIVIRAL THERAPY

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Footnotes

  • Twitter Follow Andrew Radley at @AndrRadl

  • Reporting Guideline Trend Statement: https://www.cdc.gov/trendstatement/

  • Acknowledgements The authors thank Professor Brian Williams for his contribution towards reviewing this paper. The authors also thank Dr Emma Fletcher and Professor Weiije Wang for providing statistical advice.

  • Contributors AR: study conception, planning and design, protocol preparation, analysis and interpretation of data, manuscript preparation. KM: acquisition of prescribing data, acquisition of qualitative data, manuscript preparation. JT: acquisition of testing data, analysis of testing data, manuscript preparation. BS: provision of study site staff training, manuscript preparation. JMME: methodological advice, advice on analysis, manuscript preparation. JFD: study conception and protocol preparation, manuscript preparation.

  • Competing interests AR: Honorarium from Gilead and Research Grants from Gilead and Roche. JT: Honorariums and sponsorship from Abbvie, Bristol Myers Squibb, Gilead, Janssen, Merck Roche Sharp & Dohme and Roche. BS: Honorariums and sponsorship, Gilead and Janssen. JFD: Research Grants, Honorariums and sponsorship from Abbvie, Bristol Myers Squibb, Gilead, Janssen, Merck Roche Sharp & Dohme and Roche.

  • Funding Gilead Sciences Inc.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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