Author: Pereira C, Barata F, Coutinho R, Oliveira J

Theme: Models of Care Year: 2019

Our NGO is responsible for the Low Threshold Methadone Program (LTMP) of Lisbon, a harm
reduction program based on mobile units for medical care and psychosocial support that reaches
about 1200 drug users daily.
Description of model of care/intervention:
Our patients have difficulties in seeking treatment due to social, physical and/or psychological
barriers. The aim of this intervention is to increase linkage to care and treatment through direct
accessibility to hospital. The patient is taken to hospital by car and he/she just goes once to do
exams and be evaluated by the hepatologist. If in need of treatment, medication is done in the
mobile unit when taking methadone.
This study describes an ongoing research on HCV patients in LTMP that fill the criteria for HCV
treatment. Last year, 210 HCV clinical appointments were scheduled. From those, 87 were
conducted in a hospital setting, but 27 patients were excluded due to different reasons (e.g. dropout, undetectable HCV RNA). The final sample comprises 60 patients. Most of them consider HCV a
serious health problem, however treatable. 80% are injected drug users (PWID) and 45% report
sharing drug-use materials. 10% report moderate to high alcohol consumption (AUDIT), but quality
of life is significantly below the normative scores (WHOQOL-Bref). Before this intervention, only 65
went to hepatology appointments in 22 months.
Conclusion and next steps:
These data reports on an ongoing research which aims to identify the main barriers for treatment,
but also understand whether patients improve psychological adjustment following HCV treatment.
The data from pre-treatment assessment suggest that patients are motivated for treatment, but that
quality of life is still below the normative data. We expect improvements at the post-treatment
assessment in psychological adjustment and quality of life. Overall, these data highlight the
relevance of harm reduction approaches in reaching PWID for HCV treatment while minimizing
health risks for patients and society.
Disclosure of Interest Statement:
Nothing to declare.

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