Effectiveness and Acceptance of an Intensive Hepatitis C Screening and Case Finding in a Public OTP Clinic

(A report back on Janice Pritchard-Jones's presentation - Nurses role when the Hepatitis C is cured but the Cirrhosis remains)

This topic was discussed by Janice Prichard-Jones in the 11th Viral Hepatitis Australasian Conference held in Adelaide.  

Hepatitis C is a major public health concern that needs to be made known to the community and those suffering need to know that it is a curable disease. It is the duty of the local health organisation whether it be a medical centre or a hospital to actively screen patients and do case findings for hepatitis C as a vast majority of infected people are unaware they have it. 

In their report, the speaker described the collaborative approach they had at the Sydney Local Health District in tackling this issue. General Practitioners, nurses, and other community based organisations were included in the local implementation of their action plan. They identified their target population for this health program to be those belonging to the marginalised communities. Included in their approach was also being aware of the possible comorbidities in patients with hepatitis C namely, alcohol abuse and obesity. 

The speaker mentioned the good collaboration between the Canterbury Hospital and the onsite Public OTP clinic in their hepatitis C elimination project. The speaker described the steps in the development of this project from the appropriation of a research grant to engagement and partnerships with stakeholders. Focused strategies and planning has led to improvements to patient care and participation. 

There were three key strategies described by the speaker: 

  • Strategy 1: The Four Day “Blitz:” This was an intensive health campaign where they did clinical assessments, blood tests, fibroscans, gave promotional materials/speeches and incentives to clients. During this campaign, about half of the patients who participated were HCV antibody positive. This number included those who were previously treated, undergoing current treatment, and those needing treatment. 
  • Strategy 2: Intervention for those not participating but dosing at OPT: An audit of medical records was performed to find previously diagnosed patients and subsequently contacted by hepatology nurses. In this strategy, HCV positive patients needing treatment were also discovered and commenced on treatment. 
  • Strategy 3: Intervention for those not participating and dosing at community pharmacies: Medical records were also reviewed and contacting of patients was done. These patients were reminded of their need for treatment and were liaised with a HCV prescriber and the community pharmacy. 

In conclusion, the speaker informed the audience of the success of their strategies used in hepatitis C screening and case finding. There were new patients who were referred for treatment within the first three weeks of diagnosis. The strategies were well accepted by the target population as seen in the increase in the number of clients who participated in this project. 

I am very thankful for the opportunity ASHM has given me in attending this conference. This has certainly increased my awareness and understanding of the prevalence of viral hepatitis in the community. I will be more active in doing case findings and clinic screenings in order to identify and treat patients with viral hepatitis. 



Author bio: 

Dr Samuel Cawaon is a general practitioner working in an Aboriginal Medical Service based in St George, Queensland. His clinical interests are in family medicine, Indigenous health, and hypnotherapy.   He finished his medical degree at the St Louis University College of Medicine in the Philippines in 1998. He immigrated to Australia in 2008 and worked in South Australia for several years prior to moving to Queensland.   Dr Cawaon is a Fellow of the RACGP and is also a supervisor with the Rural Vocational Training Scheme (RVTS) helping IMGs achieve fellowship. Aside from being a GP, he is also a photography enthusiast and loves playing the guitar.