Opportunistic treatment of hepatitis C in a medically supervised injection room - a client centred approach


<div class="white-popup">

            <p><a href="https://archive.hri.global/abstracts/abstracthr19/427/print" class="Td(n):h"><i class="D(ib) Va(m) icon-printer"></i> Printer friendly version</a></p>
    
    <p>ID: HR19-427</p>

    <p><i>Presenting author:</i>
                                    Nico Clark                        </p>

    <h4 class="My(0)">Presenting author biography:</h4>
            A/Prof Nico Clark is Medical Director of the Medically Supervised Injecting Room at North Richmond Community Health. He has worked as Clinical Director of Drug and Alcohol Services in South Australia and for the World Health Organization in Geneva.    
    <h1 class="Fz(1.3rem)">Opportunistic treatment of hepatitis C in a medically supervised injection room - a client centred approach</h1>

    <p>Nico Clark, David Pemberton, Kasey Elmore, Lisa Stothers, Alex Thompson, Matt Penn, Tony Weeks</p>

    <p>The Medically Supervised Injecting Room (MSIR) at North Richmond Community Health opened on the 30th of June, 2018. Located in a community health centre, it offers a unique opportunity of addressing the clinical needs of people who are not engaged with other health services. New direct acting antiviral medications (DAAs) offer the potential to treat hepatitis C simply and arrest the further spread of hepatitis C, and are freely available in Australia through any doctor. Despite this, the rate of Hepatitis C treatment in people who inject drugs in Australia remains low. </p><p>The first 2 months of operation saw 1000 people use the injecting room, with one third indicating their desire to have health concerns about hepatitis C addressed. Initial efforts to test and treat hepatitis C involved referring patients to the on-site pathology and medical services available in the community health centre, however it soon became apparent that even this relatively simplified treatment pathway was too complicated for many of our clients, as none of the first 30 clients referred in this way initiated treatment. To improve treatment uptake, we simplified the treatment process to two interactions: the first being opportunistic BBV testing and brief consultation in the MSIR, followed by a second interaction to give the results and if needed the DAA treatment, including the option of providing medication on a daily basis. While clients were given the opportunity for a fibroscan, the lack of a fibroscan did not delay treatment. </p><p>This approach resulted in a much higher rate of testing uptake and treatment initiation, with 10 of the first 30 people tested needing treatment and all 10 successfully initiating treatment. </p><p>Simplifying the treatment of hepatitis C enabled it to be provided in a injection room setting. This could be a model for other harm reduction services.</p>
</div>