The Hepatitis C Awareness Through to Treatment (HepCATT) study: improving the cascade of care for hepatitis C virus-infected people who inject drugs in England.
Antiviral Agents
/ therapeutic use
Continuity of Patient Care
Delivery of Health Care
/ organization & administration
England
Feasibility Studies
Gastroenterology
/ statistics & numerical data
Hepatitis C, Chronic
/ diagnosis
Humans
Nurse Specialists
Pilot Projects
Referral and Consultation
/ organization & administration
Substance Abuse Treatment Centers
Substance Abuse, Intravenous
/ epidemiology
Antiviral therapy
diagnosis
drug treatment services
engagement with therapy
hepatitis C
people who inject drugs
Journal
Addiction (Abingdon, England)
ISSN: 1360-0443
Titre abrégé: Addiction
Pays: England
ID NLM: 9304118
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
23
05
2018
revised:
17
09
2018
accepted:
24
01
2019
pubmed:
30
1
2019
medline:
17
7
2020
entrez:
30
1
2019
Statut:
ppublish
Résumé
Previous studies have shown low rates of diagnosis and treatment of hepatitis C virus (HCV) infection in people who inject drugs (PWID). Our aims were to test the effect of a complex intervention [Hepatitis C Awareness Through to Treatment (HepCATT)] in drug and alcohol clinics-primarily, on engagement of HCV-positive PWID with therapy and, secondarily, on testing for HCV, referral to hepatology services and start of HCV treatment. A non-randomized pilot study in three specialist addiction clinics in England comparing an intervention year (starting between September 2015 and February 2016) with a baseline year (2014), together with three control clinics. Analysis included all attendees at the intervention and control specialist addiction clinics identified as PWID. The intervention comprised the placement of a half-time facilitator in each clinic for 12 months with the brief to increase diagnosis of HCV infection within clients at those services and the engagement of diagnosed individuals with an appropriate care pathway. The facilitator undertook various activities, which could include training of key workers, direct interaction with clients, streamlining and support for hepatology appointments and introduction of dried blood-spot testing. For each clinic and period, we obtained the total number of clients and, as relevant, their status as PWID, tested for HCV, known HCV-positive, engaged with HCV therapy or treated. Compared with baseline, there was strong evidence that engagement with HCV therapy in the intervention year increased (P < 0.001) more in the HepCATT centres than controls, up Introducing a half-time facilitator into drug and alcohol clinics in England increased engagement of HCV-positive people who inject drugs with hepatitis C virus care pathways, with increased uptake also of testing, referral to hepatology and initiation of treatment.
Sections du résumé
BACKGROUND AND AIMS
Previous studies have shown low rates of diagnosis and treatment of hepatitis C virus (HCV) infection in people who inject drugs (PWID). Our aims were to test the effect of a complex intervention [Hepatitis C Awareness Through to Treatment (HepCATT)] in drug and alcohol clinics-primarily, on engagement of HCV-positive PWID with therapy and, secondarily, on testing for HCV, referral to hepatology services and start of HCV treatment.
DESIGN AND SETTING
A non-randomized pilot study in three specialist addiction clinics in England comparing an intervention year (starting between September 2015 and February 2016) with a baseline year (2014), together with three control clinics.
PARTICIPANTS
Analysis included all attendees at the intervention and control specialist addiction clinics identified as PWID.
INTERVENTION
The intervention comprised the placement of a half-time facilitator in each clinic for 12 months with the brief to increase diagnosis of HCV infection within clients at those services and the engagement of diagnosed individuals with an appropriate care pathway. The facilitator undertook various activities, which could include training of key workers, direct interaction with clients, streamlining and support for hepatology appointments and introduction of dried blood-spot testing.
MEASUREMENTS
For each clinic and period, we obtained the total number of clients and, as relevant, their status as PWID, tested for HCV, known HCV-positive, engaged with HCV therapy or treated.
FINDINGS
Compared with baseline, there was strong evidence that engagement with HCV therapy in the intervention year increased (P < 0.001) more in the HepCATT centres than controls, up
CONCLUSIONS
Introducing a half-time facilitator into drug and alcohol clinics in England increased engagement of HCV-positive people who inject drugs with hepatitis C virus care pathways, with increased uptake also of testing, referral to hepatology and initiation of treatment.
Substances chimiques
Antiviral Agents
0
Types de publication
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1113-1122Subventions
Organisme : Department of Health
ID : RP-PG-0616-20008
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/N005953/1
Pays : United Kingdom
Organisme : Department of Health
ID : RP-DG-0610-10055
Pays : United Kingdom
Organisme : National Institute for Health Research (NIHR)
Pays : International
Organisme : Department of Health Policy Research Programme
ID : 015/0309
Pays : International
Informations de copyright
© 2019 Society for the Study of Addiction.