Author: Zaganelli C, Ghosh SM

Theme: Models of Care Year: 2019

Background: Hepatitis C is prevalent within our IV substance use populations. Co-located and
integrated hepatitis C programs for these populations facilitates the cascade of care from hepatitis
detection, to completion of treatment.
Methods: In this observational study, we examine the treatment of hepatitis C for patients on an
intravenous hydromorphone program in Calgary, Alberta, Canada. Patients come up to three times a
day for treatment for illicit opioid use using intravenous hydromorphone. The full cascade of care is
completely integrated into this service seamlessly from initial evaluation, initiation of treatment for
both opioid agonist therapy and hepatitis C treatment, co-dispensing of medications, and
subsequent follow up. Wrap around services including income, housing, and justice supports are
also fully integrated into their care.
Results: Since the clinic opened in October 2018, all patients have been tested for hepatitis C,
including viral load and genotyping. Based on results, patients were triaged to see an internal
medicine physician to initiate treatment in-house. The physician was able to assess both their
substance use concerns and hepatitis C concurrently, removing the need for separate appointments.
A team based approach capitalizing on the scopes of practice of nurse practitioners, registered
nurses, and physician members has expedited the detection, evaluation, and treatment of hepatitis
C in this high risk population. Patients were overall receptive to hepatitis C treatment integration
into their addiction treatment and served as a form of motivation for patients to be a part of this
comprehensive program.
Conclusion: Seamless integration of hepatitis C treatment into an IOAT settings, along with wrap
around services, demonstrates a practical method to engage clients with intravenous substance use.
Disclosure of Interest Statement: See example below: The conference collaborators recognise the
considerable contribution that industry partners make to professional and research activities. We
also recognise the need for transparency of disclosure of potential conflicts of interest by
acknowledging these relationships in publications and presentations.

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