title: Effectiveness of interventions to increase hepatitis C testing uptake among high-risk groups: a systematic review.
abstract: BACKGROUND
  People who inject drugs are at the greatest risk of acquiring hepatitis C virus infection in many high-income countries, including those in Europe. Our review examined the effectiveness of interventions aimed at increasing hepatitis C virus testing uptake.
  
  
  METHODS
  We undertook a systematic review of controlled studies. Searches of 13 databases were supplemented with citation searching, and manual searches of reference lists and websites. Studies of interventions that aimed to increase testing uptake among high-risk groups were included. Testing uptake was our primary outcome measure of interest and secondary outcomes were engagement in follow-up services and treatment. A narrative synthesis was undertaken.
  
  
  RESULTS
  Eight controlled studies were included. Three studies examined interventions in primary care; one examined dried blood spot testing as an alternative method of testing, and two examined outreach provision. Two further studies examined interventions to improve hepatitis C management. Targeted case finding in primary care, support and training for primary care practitioners, offering alternative testing and provision of outreach testing all increased uptake of testing; however, intervention effects were variable.
  
  
  CONCLUSIONS
  Evidence from the available studies suggests that increases in testing uptake can be achieved. Careful attention needs to be paid to the resource implications associated with implementation of interventions in primary care settings and also of the potential for interventions to improve outcomes once a positive diagnosis has been made. Further research on the cost-effectiveness of the intervention approaches examined in this review is required.
authors.affiliation: 1 Centre for Public Health, Faculty of Education, Health and Community, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK l.jones1@ljmu.ac.uk.
authors.forename: Lisa
authors.initials: L
authors.lastname: Jones
authors.affiliation: 1 Centre for Public Health, Faculty of Education, Health and Community, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK.
authors.forename: Geoff
authors.initials: G
authors.lastname: Bates
authors.affiliation: 1 Centre for Public Health, Faculty of Education, Health and Community, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK.
authors.forename: Ellie
authors.initials: E
authors.lastname: McCoy
authors.affiliation: 1 Centre for Public Health, Faculty of Education, Health and Community, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK.
authors.forename: Caryl
authors.initials: C
authors.lastname: Beynon
authors.affiliation: 1 Centre for Public Health, Faculty of Education, Health and Community, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK.
authors.forename: James
authors.initials: J
authors.lastname: McVeigh
authors.affiliation: 2 Public Health Wales, Haydn Ellis Building, Maindy Road, Cardiff CF24 4HQ, UK.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Bellis
mesh_terms: D000328:Adult; D005060:Europe / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods* / Q000706:statistics & numerical data; D006526:Hepatitis C / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D015397:Program Evaluation / Q000379:methods* / Q000706:statistics & numerical data; D012306:Risk; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000453:epidemiology