PharmEC REACH study: reaching methadone users attending community pharmacies with HCV

Assessing the effectiveness, feasibility, and cost-effectiveness of nurse-led testing and treatment of hepatitis C in community pharmacies, for people on opiate substitution therapy.

Objective

The advent of direct acting antiviral medication and GP management of uncomplicated cases of hepatitis C has made access to treatment easier than ever.

Despite advances, there are still at-risk people however who, for many different reasons, are not engaged with health care services. New models of care need to be explored in a bid to offer testing and treatment to these harder-to-reach populations. This project aims to assess another possible pathway for people on opioid substitution therapy to learn about, access testing and treatment for hepatitis C through community pharmacies. 

Timeline

2021–2023.

Approach

From 2019 to 2021 an international, multicentre trial was completed assessing the effectiveness and feasibility of nurse-led HCV counselling, testing and treatment for OST clients in community pharmacies (The REACH study). The trial engaged 40 community pharmacies dispensing opioid substitution therapy (OST) across 3 countries: Australia, Scotland and Wales.

Researchers from the University of Dundee, University of Wales, Monash University and The Burnet Institute were able to demonstrate that targeted counselling, testing and treatment in community pharmacies was highly successful in:

• delivering more tests
• more cures
• a higher level of engagement in health services in this population. 

To further develop this concept into a comprehensive public health program, three further bodies of work have been undertaken by researchers at the Burnet Institute from 2022 to 2023. These include a qualitative analysis to explore acceptability, a cost-effectiveness analysis to assess the efficiency, and stakeholder engagement to assess the feasibility of this nurse-led community pharmacy model of care.

The information from these analyses will contribute to a comprehensive plan for the scale up of counselling, testing, and treatment of OST clients visiting community pharmacies.