The World Health Organization (WHO) has a target to eliminate HCV by 2030 and NHS England is on track to meet an earlier date of 2025. To achieve this, easy access to regular testing is imperative. A patient who receives a positive test can then be treated, which prevents them from developing long-term complications of liver disease, as well as onward transmission of the virus (so-called ‘treatment as prevention’). This is especially important in people who inject drugs (PWID). Once HCV has been eliminated, it is essential that testing remains easily accessible. A modelling study has demonstrated that if testing does not continue after elimination in 2025, the prevalence of HCV will increase. It is estimated that, in the absence of testing or treatment, up to 25% of PWID will be infected with HCV within five years of elimination being achieved.
In pilot studies, community pharmacies have been found to be effective locations for HCV testing, in both the UK and abroad. A pilot study on the Isle of Wight offered dry blood spot testing for HCV to anyone with a risk factor for the virus. The service was closely supported by local hospital services, with clinicians from the local hospital visiting the pharmacies to provide support with conveying positive diagnoses. The service also benefited from an automated referral system, using PharmOutcomes. A pilot in Tayside, Scotland, also used dry blood spot testing and found PWID were significantly more likely to be tested there than in other services they attended. Community pharmacies are a good place to test for HCV because they are accessible to PWID and are situated in communities where the prevalence of HCV is highest — 99% of people living in areas of highest deprivation in England are within a 20-minute walk of a pharmacy. Pharmacists also have a strong relationship with their patients, specifically PWID, which helps to overcome barriers to testing.
Access the full article, published in The Pharmaceutical Journal, here.
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