Expansion of HCV treatment access to people who have injected drugs through effective translation of research into public health policy

Scotland's experience

Sharon J Hutchinson (Lead / Corresponding author), John F Dillon, Ray Fox, Scott A McDonald, Hamish A Innes, Amanda Weir, Allan McLeod, Esther J Aspinall, Norah E Palmateer, Avril Taylor, Alison Munro, Heather Valerio, Gareth Brown, David J Goldberg

    Research output: Contribution to journalArticle

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    Abstract

    Seven years have elapsed since the Scottish Government launched its Hepatitis C Action Plan - a Plan to improve services to prevent transmission of infection, particularly among people who inject drugs (PWID), identify those infected and ensure those infected receive optimal treatment. The Plan was underpinned by industrial scale funding (around £100 million, in addition to the general NHS funding, will have been invested by 2015), and a web of accountable national and local multi-disciplinary multi-agency networks responsible for the planning, development and delivery of services. Initiatives ranged from the introduction of testing in specialist drug services through finger-prick blood sampling by non-clinical staff, to the setting of government targets to ensure rapid scale-up of antiviral therapy. The Plan was informed by comprehensive national monitoring systems, indicating the extent of the problem not just in terms of numbers infected, diagnosed and treated but also the more penetrative data on the number advancing to end-stage liver disease and death, and also through compelling modelling work demonstrating the potential beneficial impact of scaling-up therapy and the mounting cost of not acting. Achievements include around 50% increase in the proportion of the infected population diagnosed (38% to 55%); a sustained near two-and-a-half fold increase in the annual number of people initiated onto therapy (470 to 1050) with more pronounced increases among PWID (300 to 840) and prisoners (20 to 140); and reversing of an upward trend in the overall number of people living with chronic infection. The Action Plan has demonstrated that a Government-backed, coordinated and invested approach can transform services and rapidly improve the lives of thousands. Cited as "an impressive example of a national strategy" by the Global Commission on Drug Policy, the Scottish Plan has also provided fundamental insights of international relevance into the management of HCV among PWID.

    Original languageEnglish
    Pages (from-to)1041-1049
    Number of pages9
    JournalInternational Journal of Drug Policy
    Volume26
    Issue number11
    Early online date6 Jun 2015
    DOIs
    Publication statusPublished - Nov 2015

    Fingerprint

    Scotland
    Public Policy
    Health Policy
    Public Health
    Research
    Pharmaceutical Preparations
    Prisoners
    End Stage Liver Disease
    Infectious Disease Transmission
    Therapeutics
    Hepatitis C
    Fingers
    Antiviral Agents
    Costs and Cost Analysis
    Infection
    Population

    Keywords

    • HCV
    • Public health policy
    • PWID

    Cite this

    Hutchinson, Sharon J ; Dillon, John F ; Fox, Ray ; McDonald, Scott A ; Innes, Hamish A ; Weir, Amanda ; McLeod, Allan ; Aspinall, Esther J ; Palmateer, Norah E ; Taylor, Avril ; Munro, Alison ; Valerio, Heather ; Brown, Gareth ; Goldberg, David J. / Expansion of HCV treatment access to people who have injected drugs through effective translation of research into public health policy : Scotland's experience. In: International Journal of Drug Policy. 2015 ; Vol. 26, No. 11. pp. 1041-1049.
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    abstract = "Seven years have elapsed since the Scottish Government launched its Hepatitis C Action Plan - a Plan to improve services to prevent transmission of infection, particularly among people who inject drugs (PWID), identify those infected and ensure those infected receive optimal treatment. The Plan was underpinned by industrial scale funding (around £100 million, in addition to the general NHS funding, will have been invested by 2015), and a web of accountable national and local multi-disciplinary multi-agency networks responsible for the planning, development and delivery of services. Initiatives ranged from the introduction of testing in specialist drug services through finger-prick blood sampling by non-clinical staff, to the setting of government targets to ensure rapid scale-up of antiviral therapy. The Plan was informed by comprehensive national monitoring systems, indicating the extent of the problem not just in terms of numbers infected, diagnosed and treated but also the more penetrative data on the number advancing to end-stage liver disease and death, and also through compelling modelling work demonstrating the potential beneficial impact of scaling-up therapy and the mounting cost of not acting. Achievements include around 50{\%} increase in the proportion of the infected population diagnosed (38{\%} to 55{\%}); a sustained near two-and-a-half fold increase in the annual number of people initiated onto therapy (470 to 1050) with more pronounced increases among PWID (300 to 840) and prisoners (20 to 140); and reversing of an upward trend in the overall number of people living with chronic infection. The Action Plan has demonstrated that a Government-backed, coordinated and invested approach can transform services and rapidly improve the lives of thousands. Cited as {"}an impressive example of a national strategy{"} by the Global Commission on Drug Policy, the Scottish Plan has also provided fundamental insights of international relevance into the management of HCV among PWID.",
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    Hutchinson, SJ, Dillon, JF, Fox, R, McDonald, SA, Innes, HA, Weir, A, McLeod, A, Aspinall, EJ, Palmateer, NE, Taylor, A, Munro, A, Valerio, H, Brown, G & Goldberg, DJ 2015, 'Expansion of HCV treatment access to people who have injected drugs through effective translation of research into public health policy: Scotland's experience', International Journal of Drug Policy, vol. 26, no. 11, pp. 1041-1049. https://doi.org/10.1016/j.drugpo.2015.05.019

    Expansion of HCV treatment access to people who have injected drugs through effective translation of research into public health policy : Scotland's experience. / Hutchinson, Sharon J (Lead / Corresponding author); Dillon, John F; Fox, Ray; McDonald, Scott A; Innes, Hamish A; Weir, Amanda; McLeod, Allan; Aspinall, Esther J; Palmateer, Norah E; Taylor, Avril; Munro, Alison; Valerio, Heather; Brown, Gareth; Goldberg, David J.

    In: International Journal of Drug Policy, Vol. 26, No. 11, 11.2015, p. 1041-1049.

    Research output: Contribution to journalArticle

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