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Nurse-led viral hepatitis prevention
alongside shared care drug clinics
a before and after study
Pat O’Dea - Research Assistant
Manchester Urban Collaboration on Health
University of Manchester
Deborah Carr - Shared Care Support Team,
Manchester Drug Service
11th International Hepatitis C Conference
16th November 2009
Overview
•
•
•
•
Background
Methodology
Results
Conclusion
Background
• Partnership working
– Specialist drug service
– Primary care teams
– University
• Simple study to demonstrate effectiveness of
integrated practice to partners and
commissioners
• Retrospective review of shared care clinics
showed wide variation in uptake of viral hepatitis
prevention measures
Background
• RCGP guidance recommends
– Hepatitis A & B vaccination & BBV testing of IDUs on
an opportunistic basis
– GPs should offer blood tests for HAV,HBV & HVC
– Pragmatism suggests vaccination on an opportunistic
basis
Methodology
• Before & after study
• Formative evaluation
• Aim to increase BBV prevention measures
– 6 LES practices
– June - Sept 2007 =100 service users
– June - Sept 2008 =106 service users
Methodology
• Interventions delivered by specialist
support nurse
– Initial audit
– Action plan in consultation with PHCT
– BBV vaccination & testing concurrent with
drug treatment
– Second audit
• Outcome measure
– Vaccination and testing uptake
Results
Increase in uptake of viral hepatitis
prevention measures
100
90
80
70
60
% 50
40
30
20
10
0
2007
Any BBV test
3rd Hep B
2nd Hep B
1st Hep B
2nd Hep A
1st Hep A
2008*
* p<0.01
Conclusion
• IDUs uptake of viral hepatitis prevention
measures in line with RCGP guidance can be
improved using this model of practice
• Effective – Increased uptake of viral hepatitis
prevention measures when delivered alongside
LES drug treatment clinic
• Efficient – Uses existing resources
• Demonstrated benefits of partnership working