Nurse-delivered community testing and treatment of patients for hepatitis C at community pharmacies made treatment more accessible and a cure more likely, research has found.
A study led by the University of Dundee found that one of the most accessible ways to reach people with hepatitis C was for nurses in community pharmacies to test people as they came in for methadone treatment.
The researchers believe a simplified care pathway for vulnerable groups of patients who may struggle to engage with traditional healthcare models could offer a better cure to the disease compared to conventional hepatitis C care.
This type of nurse-led community testing could be ‘key’ to the global effort to eliminate the disease by 2030, the researchers said, with more than 95% of cases already cured because of accurate diagnostic testing and efficient treatment.
After looking at 40 pharmacies in Scotland, Wales and Australia, the researchers published the results in Alimentary Pharmacology and Therapeutics and highlight a model well suited to small pharmacies.
Hepatitis C is a virus carried in the blood that causes liver inflammation. Left untreated can cause liver cirrhosis and cancer and is often transmitted via intravenous drug use.
In the UK, it is estimated that there are around 118 000 people with hepatitis C. Current diagnostic tests are very accurate, and treatment is 95% effective; however, it can be challenging to reach the vulnerable groups affected by the disease.
Dr Christopher Byrne from the University of Dundee said: ‘The tools to achieve elimination of hepatitis C as a public health threat are broadly known. However, recent research has suggested that the 2030 target may be missed due to bottlenecks in linkage to care for key affected patient groups, like people who use drugs.’
To assess the effectiveness of nurse-delivered point-of-care testing in community pharmacies, the researchers worked with 40 pharmacies across Scotland, Wales and Australia. Each pharmacy was randomly chosen as either one offering conventional care or one offering the new care pathway led by community nurse testing. The study aimed to find a simplified way for vulnerable groups to engage in healthcare.
Dr Byrne added: ‘Our study is the first to implement nurse-led point-of-care testing – with results available on the same day – and treatment for hepatitis C in community pharmacies.’
He added: ‘The research provides evidence that engaging at-risk individuals and curing them of their infection is feasible and safe in community pharmacies, with little need for extra hospital visits, and that community pharmacists can play an important role in hepatitis C care.’
With fewer than ten years remaining to meet the WHO target of eliminating hepatitis c as a public health threat, substantial efforts are required to improve diagnosis and treatment of the virus among key affected patient groups.
Dr Byrne said: ‘As policy makers and health service commissioners evaluate their elimination efforts to date and consider the current trajectory toward the 2030 targets, this study provides an additional useful approach to improving hepatitis C outcomes for people who use drugs.’