Author: Margaret Bourke Gail Hawthorn Eamon Keenan P Aidan McCormick

Theme: Models of Care Year: 2021

Background During the COVID pandemic 641 persons applied to enter Primary Care Opioid Substitution treatment (OST), a large number were homeless in temporary transient accommodation or on the streets. To maximise clinic safety PPE and other measure were introduced. All were tested for Hepatitis C antibodies, PCR to treat as soon as possible. Model of Care Admit to 0ST, Test for Hepatitis C antibody, PCR If PCR Positive, Fibro scan/ FIB 4, LFTS, Platelets, AFP and Coagulation Screen Treat with pan genotypic and psychosocial supports for 8 weeks Effectiveness During the initial surge with ‘lock down’ March 27th 2020 to easing of restrictions June 8th no new treatments were initiated. With reopening: All were tested for Hepatitis C antibodies and PCR to treat as soon as possible. 39 new patients were identified for treatment. Fibro scan and Fib 4 identified four with advanced cirrhosis, referred to Hepatology. Four were reinfections previously treated, three have completed re-treatment and one has failed to engage. 34 patients were treated with pan genotypic regimens for 8 weeks regardless of continuing drug or alcohol use. This reduced or ceased as confirmed by urinalysis. Treatment was dispensed on site at OST Clinics. Psychosocial supports provided SVR was achieved in all. Incidence of COVID 19 in local Addiction Service was

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