1 / 16

HepCATT: Increasing Hepatitis C Awareness and Treatment in Drug Treatment Settings

This pilot intervention aims to boost diagnosis and treatment of hepatitis C in drug treatment settings. The project involves a multidisciplinary team and various strategies such as training, education, and peer support. The outcome shows a significant increase in engagement with HCV treatment services, testing uptake, and treatment referrals in the intervention sites. The findings highlight the effectiveness of HCV Nurse Facilitators in improving the care pathway. The intervention, though complex, has proven successful, warranting further study for replication and cost-effectiveness assessment.

josephdmiller
Download Presentation

HepCATT: Increasing Hepatitis C Awareness and Treatment in Drug Treatment Settings

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Hepatitis C: Awareness Through to Treatment (HepCATT): Pilot of an intervention designed to increase diagnosis and treatment of patients with hepatitis C virus infection in drug treatment settings Graham Harrison, William Irving, Matt Hickman, HepCATT Team

  2. Acknowledgements • Work was funded by Department of Health (HepCATT), NIHR HPRU for Evaluation of Interventions. HepCATT Team:- • University of Nottingham: Will Irving, Graham Harrison, Brian Thomson • University of Bristol: Matt Hickman, Kirsty Roberts, Cherry Ann Waldron, Peter Vickerman, Zoe Ward, Rosy Reynolds, John Macleod, Natasha Martin (UCSD) • Hepatitis C Trust: Archie Christian, Stuart Smith, Emma Ward, Charles Gore • LSHTM: Magdalena Harris, Oliver Bonnington, Tim Rhodes • Nottingham University Hospital Trust: Stephen Ryder • Queen Mary University of London: Graham Foster • PHE: Sema Mandal, Ruth Simmons, Mary Ramsay • United Lincolnshire Hospital Trust: Aravamuthan Sreedharan, Karen Murray • Walsall Healthcare Trust: Amanda Hughes • Royal Liverpool and Broadgreen University Hospitals: Paul Richardson, Helen Caldwell, Roxanne Gore • CGL: Claire Walters, Annette Orton, Penelope Lee • Addaction Lincolnshire: Karen Ratcliff, Paul Newton • Addaction Liverpool: Stephen Jennings, Sandra Oelbaum, Stephen Purcell, Jo Whitfield, • Robbie Dreha, Tara Byrne, Debbie Thomas, Elisabeth Fraser • Addaction Central Office: Charlotte Simpson, Jo Bevan, Coleen Homan, Dave Reeve, Clare Hathaway • University Hospitals of Leicester: Martin Wiselka • Cambridge University Hospitals Trust: William Gelson, Darren Day • University Hospitals Coventry and Warwickshire: Esther Unit

  3. HCV Lead/facilitator in drug services • Drugs services should designate a hepatitis lead for the service. The lead should have the knowledge and skills to promote hepatitis B and C testing and treatment and hepatitis B vaccination. • Lack of robust trials on promotion of HCV treatment in community drug clinics… Hepatitis B and C: ways to promote and offer testing to people at increased risk of infection NICE public health guidance 43 2012 guidance.nice.org.uk/ph43

  4. Background - HepCATT • 3 UK cities for 1 year: Liverpool, Lincoln, Walsall • Complex Intervention • HCV Nurse facilitator (0.5) working with main drug treatment centre & linking to HCV specialist care • Increase uptake of HCV testing, referral & engagement • Staff training, staff and client education initiatives • HCV assessment a routine part of client management • Dried Blood Spot Testing • Quicker referrals with flexible appointment times • Improved communication between 2ry care and patient • Enhancing peer support and buddy systems

  5. Intervention ingredients & main drivers in bold

  6. Pilot Design • Non-randomised trial • 3 intervention & 3 control sites • Main Outcome/Ho: • Does HepCATT increase engagement with HCV treatment services/ HCV treatment readiness? • Secondary Outcomes/Ho: • Does HepCATT increase • uptake of HCV testing • referral to HCV specialist services • HCV treatment

  7. Engagement increases in all 3 intervention sites

  8. Increased Engagement – ~10-fold in HepCATT sites & 26-fold vs control Modest I2 heterogeneity: 51% (control); 44% (intervention). Strong evidence for an intervention effect - interaction Odds Ratio - 26 (95% CI 7 – 100)

  9. Uptake of HCV testing increases in all 3 intervention sites

  10. Increase in HCV testing – more heterogeneity Strong evidence for increase in HCV testing in intervention sites - interaction odds ratio of 3.7 (95%CI 1.7 – 8.1) High I2 heterogeneity: 50% (control); 96% intervention).

  11. Uptake of HCV testing increases in all 3 intervention sites

  12. Increase in referral from community drug agencies Strong evidence for increase in referral in intervention sites - interaction odds ratio of 10.3 (95% CI 3.13–34.0) High I2 heterogeneity: 81% (control); 94% intervention).

  13. Uptake of HCV treatment increases in all 3 intervention sites

  14. Increase in HCV treatment of PWID supported by community drug agencies Strong evidence for increase in referral in intervention sites - interaction odds ratio of 28.3 (95% CI 9.9-80.8) No I2 heterogeneity: 0%. No clients started treatment in site 3 so one added to fit intervention effect.

  15. Summary and Implications • Strong evidence that HCV Nurse Facilitators can improve HCV Care pathway in community drug agencies • Increased HCV treatment readiness/engagement; uptake of HCV testing; referral; HCV treatment • Complex intervention – multiple ingredients – locally defined/situation specific • Intervention development/ pilot non-randomised study • Manualise intervention • Replicate/ extend in larger trials (e.g. step wedge) • Determine cost-effectiveness

  16. Is HepCatt Cost-effective • Yes highly…! • The cost-effectiveness of interventions to improve case finding and engagement with HCV treatment for people who inject drugs in the UK. • Zoe Ward, Poster number 666, Wednesday 12:45-2:15. • Ask: Zoe.ward@bristol.ac.uk; matthew.hickman@bristol.ac.uk; peter.Vickerman@bristol.ac.uk

More Related