Integrating Hepatitis C Testing and Treatment Into Community Healthcare Settings for Those Who Inject Drugs: Formulating Recommendations

Author: Gabriele Vojt Lawrie Elliott David Liddell Brian Stephens Jan Tait John Dillon Matthew Hickman Sharon Hutchinson Paul Flowers Paul

Theme: Epidemiology & Public Health Research Year: 2022

Background: Engagement with Hepatitis C Virus (HCV) services by people who inject drugs (PWID) is
a major barrier to HCV testing and treatment. As part of an NIHR funded research programme
(EPIToPe) in Tayside, evidence suggests that upscaling outreach healthcare services to offer HCV
care is instrumental to eliminating HCV (Palmateer et al, 2021). We report the key recommendations
anual_recommedations_FINAL_VERSION_Sep2021.pdf) on how to integrate HCV testing and
treatment into an existing healthcare service from the lessons learned in Tayside. We also report on
the methods at how we arrived at these recommendations.
Methods: We applied a four-stage method and analysis approach. (1) We mapped out the
behavioural steps in the HCV patient pathway, (2) we identified the barriers and facilitators to each
behavioural step. (3) We coded these into sets of recommendations using the Behaviour Change
Wheel and implementation sciences. (4) We synthesized and sense-checked the recommendations
via co-production with stakeholders in Tayside, wider Scotland and England.
Results: The key recommendations suggest to implement a nurse-led community HCV model,
integrate peer workers with lived experience into the health service, quick access to HCV treatment
and implement an infrastructure to ensure ongoing support for PWID across harm reduction and
complimentary services (e.g. housing, social welfare). Ideally, these services should be co-located in
the same building to maximize on any engagement with PWIDs. Recommendations also include
specific modes of training, confidence building and skill retention for staff.
Conclusion: The key findings of the recommendations align with existing guidance from
implementation and health science. Mapping out the patient care pathway, identifying key actions,
and sense-checking recommendations with key stakeholders increase knowledge exchange and
application of research findings into practice. Using the suggested method therefore provides
opportunities to demonstrate clinical impacts of research.
Disclosure of Interest Statement: None.

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