Andrew Radley1, Karen Melville2, Jan Tait3, Brian Stephens3, Josie M M Evans4, John F Dillon5. 1. NHS Tayside, Directorate of Public Health, Kings Cross Hospital, Dundee, UK. 2. NHS Tayside, Tayside Substance Misuse Services, Dundee, UK. 3. NHS Tayside, Gastroenterology Department, Ninewells Hospital and Medical School, Dundee, UK. 4. Division of Health Sciences and Sport, University of Stirling, Stirling, UK. 5. Division of Cardiovascular Medicines and Diabetes, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.
Abstract
OBJECTIVE: Comparison of uptake of dried blood spot testing (DBST) for hepatitis C virus (HCV) infection between community pharmacies and established services. DESIGN: Quantitative evaluation of a service development with qualitative process evaluation undertaken in parallel. SETTING: Six pharmacies from 36 community pharmacies within Dundee City, a large urban settlement with high levels of socioeconomic deprivation. PARTICIPANTS: Patients in receipt of opioid substitution therapy (OST) not tested for HCV within 12 months. The 6 pharmacies provided OST for approximately 363 patients from a cohort of 1385 patients within Dundee City. INTERVENTION: Provision of DBST by pharmacists. MAIN OUTCOME MEASURE: Receipt of DBST between January and December 2014. RESULTS: 43 of 143 service users with no record of testing from the 6 community pharmacies accepted DBST. Of 561 from the remaining 1022 service users with no record of testing, 75 were tested for HCV (30% vs 13%). The OR for increased uptake of testing within the 6 pharmacies was 2.25 (95% CI 1.48 to 3.41, Z statistic=3.81, p=<0.0001) compared with other services. The DBST taken by the pharmacies provided 12 patients with a reactive test. The process evaluation identified key themes important to staff and recipients of the service. A logic model was constructed. LIMITATIONS: Non-experimental service evaluation performed in community pharmacies records service activity in one location across a single time period. INTERPRETATION: Some evidence that DBST from community pharmacies may be feasible. Service users received the service positively. Staff reported that DBST was straightforward and achievable.
OBJECTIVE: Comparison of uptake of dried blood spot testing (DBST) for hepatitis C virus (HCV) infection between community pharmacies and established services. DESIGN: Quantitative evaluation of a service development with qualitative process evaluation undertaken in parallel. SETTING: Six pharmacies from 36 community pharmacies within Dundee City, a large urban settlement with high levels of socioeconomic deprivation. PARTICIPANTS: Patients in receipt of opioid substitution therapy (OST) not tested for HCV within 12 months. The 6 pharmacies provided OST for approximately 363 patients from a cohort of 1385 patients within Dundee City. INTERVENTION: Provision of DBST by pharmacists. MAIN OUTCOME MEASURE: Receipt of DBST between January and December 2014. RESULTS: 43 of 143 service users with no record of testing from the 6 community pharmacies accepted DBST. Of 561 from the remaining 1022 service users with no record of testing, 75 were tested for HCV (30% vs 13%). The OR for increased uptake of testing within the 6 pharmacies was 2.25 (95% CI 1.48 to 3.41, Z statistic=3.81, p=<0.0001) compared with other services. The DBST taken by the pharmacies provided 12 patients with a reactive test. The process evaluation identified key themes important to staff and recipients of the service. A logic model was constructed. LIMITATIONS: Non-experimental service evaluation performed in community pharmacies records service activity in one location across a single time period. INTERPRETATION: Some evidence that DBST from community pharmacies may be feasible. Service users received the service positively. Staff reported that DBST was straightforward and achievable.
Entities:
Keywords:
ANTIVIRAL THERAPY; HEPATITIS C; PRIMARY CARE
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