Client Acceptability And Feasibility Of Expanded Access To Direct Acting Antiviral Therapy For Hepatitis C At The Kirketon Road Centre

Author: Chronister KJ, Lothian R, Kearley J, Gilliver R, Read P

Theme: Epidemiology & Public Health Research Year: 2017

Background: The Kirketon Road Centre (KRC) is a publicly funded primary health care service in Kings Cross, Sydney providing prevention, treatment and care of viral hepatitis in people who inject drugs. Since the introduction of direct acting antivirals (DAAs) in Australia, KRC has sought to support treatment by offering clients daily or weekly medication through our opioid substitution treatment (OST) program regardless of participation in OST or opioid dependence. The aim of this study was to evaluate the acceptability and feasibility of delivering DAAs daily, and the impact on the provision of care to other clients.

Methods: A cross-sectional survey was conducted six months into the program to ascertain feedback and satisfaction of clients accessing KRC, including those receiving DAAs through a daily treatment plan, those on treatment who managed their own DAA prescriptions, and those not on treatment. Data were analysed to determine acceptability of offering daily dosing plans.

Results: A total 117 clients completed the survey: 32 on HCV treatment (10 receiving DAAs daily through KRC), and 85 accessing other services at KRC. More than 90% of clients on DAAs were satisfied or very satisfied with their treatment plan including frequency of visits and discussion of risks, benefits, and side effects of treatment. All (100%) of those receiving DAAs through the OST program found it very helpful. Among OST clients, only four of 25 (16%) indicated the wait for dosing OST was now longer. Only three of 85 (4%) clients accessing clinical or needle syringe program services indicated that the increased number of people waiting for medications affected their access to these services.

Conclusion: This study demonstrates that providing daily or weekly dosing of DAAs through an OST program within a primary health care setting is both feasible and acceptable, and has minimal impact on other service provision.

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