Theme: Models of Care Year: 2019
Background:
There are patients with hepatitis C virus (HCV) infection within NHS Grampian who are undiagnosed
or untreated. NHS Grampian has a large rural population which is challenging in designing specialist
services to aid diagnosis and treatment. People receiving opioid substitution therapy (OST) from
community pharmacies are a key target group for testing. The Scottish Government is committed to
the elimination of HCV by 2030 and recognise that innovative and collaborative working is required to
achieve this.
Description of model of care/intervention:
Two Pharmacies (A & B) in a rural town were identified as providing OST to patients known to
substance misuse services (SMS). Pharmacy A: demonstrated a proactive approach offering blood
borne virus (BBV) testing on dry blood spot (DBS) on site. The pharmacy contacted the Hepatology
Nurse Specialist (HNS) directly via email or telephone to refer patients. The patient was reviewed by
the HNS within the pharmacy and a full assessment including fibroscan was performed before
treatment initiation. Pharmacy B did not participate.
Effectiveness:
Total number of patients = 56.
Pharmacy A: 25 (45%) were attending for OST and DBS testing was performed on all 25 (100%). 5
(20%) were HCV antibody positive, PCR positive and all 5 /5 (100%) were treated with a DAA. 3 (60%)
achieved a Sustained Viral Response (SVR), 2 (40%) are awaiting results.
Pharmacy B: 31 (55%) attended for OST, 25/31 (81%) had been tested previously (9 at GP practice and
16 via other means inc. Antenatal screening, during inpatient admissions and whilst incarcerated) 4
(16%) were HCV antibody positive, PCR positive and been treated achieving a SVR. 6 (19%) have never
been tested.
Conclusion and next steps:
A proactive pharmacy who works collaboratively alongside the HNS has proven that 100% of
patients on OST can be screened and tested leading to prompt treatment of HCV and is invaluable in
working towards HCV elimination.
Disclosure of Interest Statement:
N/A