User Driven HCV Clinic On 4 Wheels


Author: Bjørnestad R, Lygren O.J, Skoftedalen J.G

Theme: Models of Care Year: 2018

Background:
People who use drugs are at high risk of HCV infection. In Norway there is about 8000
people in substitution treatment, (OST) approximal 50% of those have hepatitis C infections
and are in higher risk of chronic disease.
Each year there are around 2000 people inpatient on institutions for short or long term
treatment.
Treatment centers do not priorities HCV testing or examination (Fibroscan) for their patients.
People who use drugs lose their chance to get started or even examination for hepatitis C
during drug treatment.
Approach:
As a drug user union we are involved at system level advocacy regardless Hepatitis C in our
country. We speak out about the need to treat all patient regardless of liver stage or
genotype. Finally we achieved that early 2018. We started cooperation with a national
umbrella organization (Fagrådet) and made a project plan for a user driven HCV clinic on 4
wheels. We bought a caravan, we hired nurses and staffed the caravan with peers.
Institutions in Norway who treats people for drug problems will have visits from our clinic on
wheels. On our team we have doctor Dr. Olav Dalgard who will be responsibility for progress.
Inpatients can voluntary get examination with Fibroscan. Our nurses will collaborate with
doctor on institution for further treatment. If needed.
Outcome:
Our goal is to meet up and examination 750 people inpatient on institution while project are
running. All patients on site must have declared their status que regardless of active HCV
before screening can be done. Their will also be a valuable peer to peer education on site
while the “clinic” are visiting different institutions. More people will be informed about the risk
of prevention and models of care.
Project start summer 2018 and will arrange 12 trips during 18 months. Each trip will last for 4
days and our “HCV clinic on 4 wheels” will visit several institutions each trip.
Project will end by December 2019.
Conclusion:
As this project just started this summer it is to early to tell more about challenges and
conclusions, but we will have some examples by the INHSU conference sept, Porto,
Portugal.
We hope to show the conference delegates how a drug user union in a small country can be
part of a big problem world vide and nationally. We are sure our project will create a huge
grade of awerness among politicians, professionals and others.
Our next step in develop the project will be to reach other low threshold environments. There
is a huge need to be where people are. In their own environment.
Disclosure of Interest Statement:
MSD, AbbVie and Gilead, are involved funding parts of this project.
Also the directorate of health in Norway.

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