Quantitative evaluation of an integrated nurse model of care providing hepatitis C treatment to people attending homeless services in Melbourne, Australia

Brendan L. Harney, Bradley Whitton, Cheryl Lim, Emma Paige, Belinda McDonald, Sarah Nolan, David Pemberton, Margaret E. Hellard, Joseph S. Doyle

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)

Abstract

Background: The prevalence of hepatitis C virus (HCV) has been reported to be high among people experiencing homelessness. People who are homeless often have multiple needs that may take precedence over HCV testing and treatment. We quantitatively evaluated the outcomes of a service providing HCV treatment to people attending homeless services. Methods: Clients attending homeless services were referred to a nurse specialising in HCV-related care. The nurse provided HCV testing, education and case-management while prescriptions were provided by an affiliated doctor. Logistic regression was used to explore factors associated with treatment commencement. Results: Fifty-two clients referred (78%) underwent testing, thirty-nine were HCV-RNA positive among whom 18 (46%) reported sleeping rough and 29 (74%) reported injecting drug use; 66% had injected less than three months ago. Twenty-four (62%) clients commenced treatment, of whom thirteen (54%) had a sustained virological response test; all were cured. Treatment commencement was lower among people who reported sleeping rough (aOR 0.15, 95%CI 0.029-0.73). There was no difference in treatment commencement based on injecting drugs (aOR 1.06, 95%CI 0.21–5.2). Conclusion: Most clients’ commenced treatment and the majority were successfully cured using a dedicated nursing service. Clients who reported sleeping rough may still face personal and/or system level barriers to HCV treatment.

Original languageEnglish
Number of pages4
JournalInternational Journal of Drug Policy
DOIs
Publication statusAccepted/In press - 10 Apr 2019

Keywords

  • Hepatitis C
  • Homeless
  • Injecting drug use

Cite this

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title = "Quantitative evaluation of an integrated nurse model of care providing hepatitis C treatment to people attending homeless services in Melbourne, Australia",
abstract = "Background: The prevalence of hepatitis C virus (HCV) has been reported to be high among people experiencing homelessness. People who are homeless often have multiple needs that may take precedence over HCV testing and treatment. We quantitatively evaluated the outcomes of a service providing HCV treatment to people attending homeless services. Methods: Clients attending homeless services were referred to a nurse specialising in HCV-related care. The nurse provided HCV testing, education and case-management while prescriptions were provided by an affiliated doctor. Logistic regression was used to explore factors associated with treatment commencement. Results: Fifty-two clients referred (78{\%}) underwent testing, thirty-nine were HCV-RNA positive among whom 18 (46{\%}) reported sleeping rough and 29 (74{\%}) reported injecting drug use; 66{\%} had injected less than three months ago. Twenty-four (62{\%}) clients commenced treatment, of whom thirteen (54{\%}) had a sustained virological response test; all were cured. Treatment commencement was lower among people who reported sleeping rough (aOR 0.15, 95{\%}CI 0.029-0.73). There was no difference in treatment commencement based on injecting drugs (aOR 1.06, 95{\%}CI 0.21–5.2). Conclusion: Most clients’ commenced treatment and the majority were successfully cured using a dedicated nursing service. Clients who reported sleeping rough may still face personal and/or system level barriers to HCV treatment.",
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author = "Harney, {Brendan L.} and Bradley Whitton and Cheryl Lim and Emma Paige and Belinda McDonald and Sarah Nolan and David Pemberton and Hellard, {Margaret E.} and Doyle, {Joseph S.}",
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Quantitative evaluation of an integrated nurse model of care providing hepatitis C treatment to people attending homeless services in Melbourne, Australia. / Harney, Brendan L.; Whitton, Bradley; Lim, Cheryl; Paige, Emma; McDonald, Belinda; Nolan, Sarah; Pemberton, David; Hellard, Margaret E.; Doyle, Joseph S.

In: International Journal of Drug Policy, 10.04.2019.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Quantitative evaluation of an integrated nurse model of care providing hepatitis C treatment to people attending homeless services in Melbourne, Australia

AU - Harney, Brendan L.

AU - Whitton, Bradley

AU - Lim, Cheryl

AU - Paige, Emma

AU - McDonald, Belinda

AU - Nolan, Sarah

AU - Pemberton, David

AU - Hellard, Margaret E.

AU - Doyle, Joseph S.

PY - 2019/4/10

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N2 - Background: The prevalence of hepatitis C virus (HCV) has been reported to be high among people experiencing homelessness. People who are homeless often have multiple needs that may take precedence over HCV testing and treatment. We quantitatively evaluated the outcomes of a service providing HCV treatment to people attending homeless services. Methods: Clients attending homeless services were referred to a nurse specialising in HCV-related care. The nurse provided HCV testing, education and case-management while prescriptions were provided by an affiliated doctor. Logistic regression was used to explore factors associated with treatment commencement. Results: Fifty-two clients referred (78%) underwent testing, thirty-nine were HCV-RNA positive among whom 18 (46%) reported sleeping rough and 29 (74%) reported injecting drug use; 66% had injected less than three months ago. Twenty-four (62%) clients commenced treatment, of whom thirteen (54%) had a sustained virological response test; all were cured. Treatment commencement was lower among people who reported sleeping rough (aOR 0.15, 95%CI 0.029-0.73). There was no difference in treatment commencement based on injecting drugs (aOR 1.06, 95%CI 0.21–5.2). Conclusion: Most clients’ commenced treatment and the majority were successfully cured using a dedicated nursing service. Clients who reported sleeping rough may still face personal and/or system level barriers to HCV treatment.

AB - Background: The prevalence of hepatitis C virus (HCV) has been reported to be high among people experiencing homelessness. People who are homeless often have multiple needs that may take precedence over HCV testing and treatment. We quantitatively evaluated the outcomes of a service providing HCV treatment to people attending homeless services. Methods: Clients attending homeless services were referred to a nurse specialising in HCV-related care. The nurse provided HCV testing, education and case-management while prescriptions were provided by an affiliated doctor. Logistic regression was used to explore factors associated with treatment commencement. Results: Fifty-two clients referred (78%) underwent testing, thirty-nine were HCV-RNA positive among whom 18 (46%) reported sleeping rough and 29 (74%) reported injecting drug use; 66% had injected less than three months ago. Twenty-four (62%) clients commenced treatment, of whom thirteen (54%) had a sustained virological response test; all were cured. Treatment commencement was lower among people who reported sleeping rough (aOR 0.15, 95%CI 0.029-0.73). There was no difference in treatment commencement based on injecting drugs (aOR 1.06, 95%CI 0.21–5.2). Conclusion: Most clients’ commenced treatment and the majority were successfully cured using a dedicated nursing service. Clients who reported sleeping rough may still face personal and/or system level barriers to HCV treatment.

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