Tolerância Zero

Author: Paula Carriço

Theme: Models of Care Year: 2023

This idea began from the lack of Hepatitis C tests in patients on the Opioid Substitution Program at Figueira da Foz, Portugal. This meant they weren’t being diagnosed and treated. So the teams from Equipa de Tratamento of Figueira da Foz (ETFF), Associação Fernão Mendes Pinto (AFMP) and the Infectious Diseases Unit (IDU) of Coimbra’s University Hospital created a program to test, diagnose and treat this population.

Description of model of care/intervention:
This intervention had three phases:
First: Antibody test, through rapid test, done at ETFF’s and AFMP’s facilities. Given a positive result, the patient would move on.
Second: Antibody PCR Test, done at ETFF, which was provided a Fibroscan machine for that purpose. If positive, the patient would move on.
Third: Follow-Ups at IDU, Medical Diagnosis and Treatment. The patient would be put in contact with AFMP, that scheduled an appointment for a medical diagnosis and treatment at the IDU. They would also provide transportation to the Hospital on those days.
This innovated for a mean of decentralization of tests to the Units that are in direct contact with the patients, allowing a following through this process that wasn’t occurring.

Using this protocol, between November, 2021 and January, 2023, were tested 69 patients with rapid tests (31 of which positive), 44 with PCR tests (10 of which positive), 12 patients were signaled for a first appointment at the IDU, 3 were awaiting treatment and 5 completed successfully the treatment.

Conclusion and next steps:
These results, though scarce, represent patients that normally wouldn’t be tested for Hepatitis C, and if positive, wouldn’t consider start a treatment, because of hardships in accessibility and demotivation for the treatment. The control and support the teams provided and the easiness of testing the virus presence motivated patients to adhere and, as a final result, treated patients that wouldn’t be treated on normal circumstances.

Disclosure of Interest Statement: 
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.
With research support from the AIDFM/Gilead grant.

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