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Research
Improving access to treatment for patients with chronic hepatitis C through outreach
  1. Ahmed Mohamed Elsharkawy1,
  2. Carolyn Miller2,
  3. Andrea Hearn3,
  4. Gertrud Buerstedde4,
  5. Ashley Price5,6,
  6. Stuart McPherson2,6
  1. 1Liver Unit, University Hospitals Birmingham, Birmingham, UK
  2. 2Liver Unit, Freeman Hospital, Newcastle Upon Tyne, UK
  3. 3Plummer Court Addiction Service, Newcastle upon Tyne, UK
  4. 4Bridge View Drug Treatment Centre, Newcastle upon Tyne, UK
  5. 5Department of Infectious Diseases, Royal Victoria Infirmary, Newcastle Upon Tyne, UK
  6. 6Institute of Cellular Medicine, Newcastle University,  Newcastle Upon Tyne, UK
  1. Correspondence to Dr Ahmed Mohamed Elsharkawy, Liver Unit, University Hospitals Birmingham, Edgbaston, Birmingham B15 2TH, UK; ahmed.elsharkawy{at}uhb.nhs.uk

Abstract

Background Chronic hepatitis C infection (HCV) is common in injecting drug users and is a major cause of liver disease. Antiviral treatment can ‘cure’ HCV, but is frequently associated with side effects and requires regular monitoring. Non-attendance at hospital appointments is frequent. To try and improve attendance and increase the number of current and previous injecting drug users treated we developed three outreach clinics.

Objective To review the outcome of patients referred to the outreach clinics.

Methods Retrospective service review of three clinics at drug treatment centres in Newcastle and Northumberland. Data was collected on attendance rates, patient demographics, treatment rates and outcomes.

Results 141 referrals were received across the three sites with an overall attendance rate of 75% (106 patients, 79% men and median age 36), which compared favourably with that at our hospital (50%). All patients were on methadone/subutex. 45% were infected with Genotype 1 HCV. 10% were cirrhotic. To date, 30% have started treatment and 21% are waiting to start or are still in workup. 13% elected to delay treatment due to early stage disease and 11% were not ready for treatment on psychological or social grounds. Only 12% failed to attend follow up after initial assessment. To date, 24 patients have completed full courses of treatment with sustained viral response in 13 patients. Results are awaited for seven patients.

Conclusions The development of outreach clinics for HCV in drug treatment centres can substantially improve clinic attendance and increase access to treatment in this marginalised group.

  • Chronic Hepatitis
  • Chronic Viral Hepatitis
  • Hcv
  • Hepatitis C

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