Assessment Of Hepatitis C Treatment Access Barriers Among PWID In The Catalan Substance Abuse Treatment Network

Author: Ibañez N, Pila M, Major X, Buira E, Gasulla L, Muga R, Colom J

Theme: Epidemiology & Public Health Research Year: 2018

Background: High rates of HCV infection occur in individuals with Substance Use Disorder (SUD), particularly among People Who Inject Drugs (PWID). In Catalonia it is estimated that over 60% of PWID are on opioid substitution therapy (OST). OST is provided by Outpatient Drug Treatment Centres (ODTC). However, HCV treatment is provided in hospital-based specialized units. We aimed to identify the main barriers to access HCV treatment by patients attending ODTC. Approach: Between February and June of 2017, the 61 Outpatient Drug treatment Centres (ODTC)) of the Catalan Health Care System were administered an online questionnaire. The survey assessed the on-site screening tool, the barriers and facilitators of the referral pathways and procedures. Every centre established a key professional that represented the centre in the assessment process. Outcome: 52 centres (85%) completed the survey. 83% of these centres had access to the Catalan Shared Patient Health Record System (HCC3) were any clinician from the National Health System uploads patients’ information. Only 67% provide HCV screening onsite. 39% of centres were able to make appointments directly with specialists for their patients, 31% of ODTC made the appointments with GP’s patients only, and the rest of OTDC told patients to make the appointment with their GP by themselves. The main weak points in the referral procedure were: patient nonattendance to the appointments (38%), the complexity and bureaucracy of the referral to the specialist (18%) and waiting lists in the hospitals (18%). Conclusion: There are still a significant number of centres which cannot provide screening on site. In those cases, serological rapid tests or Blood Spot Test should be implemented. The current status of the OTDC referral procedure pose serious barriers to facilitate the access of HCV infected patients to specialists. Improvements should include either a standard single-step referral pathway (eliminating the need of GPs as proxies) or/and being able to diagnose and treat directly in every OTDC. Disclosure of Interest Statement: There are no conflicts of interest detected.

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