Pilot Study: Combining Formal and Peer Education with FibroScan to Increase HCV Screening and Treatment in Persons who use Drugs.
Treatment uptake for hepatitis C virus (HCV) infection remains low in persons who inject drugs (PWID), due to lack of knowledge and low perceived need for treatment. Therefore, we conducted a pilot study to assess the influence on knowledge and willingness for HCV screening and treatment among persons who use drugs (PWUD) by combining formal and peer education with FibroScan measurement.



Clients of the Center for Alcohol and other Drug problems (CAD) in Limburg (Belgium) were randomized into a control group, which received the standard of care, and an intervention group, which received an innovative combination of formal and peer education followed by FibroScan. Knowledge of HCV infection and willingness for screening and treatment were evaluated at baseline, after intervention and 1 and 3months after intervention by means of questionnaires.



Baseline knowledge was similar for the control (n=27) and the intervention group (n=25) (58 vs. 59%; p=0.67). Immediately after the information session, knowledge increased to 86% (p<0.001) in the intervention group. After 3months, knowledge decreased significantly (69%; p=0.01). No significant changes in knowledge were found in the control group. Baseline willingness for treatment was 81% in both the control and intervention groups, but after 1 month decreased in the control group (44%) and remained stable in the intervention group (75%). Differences in actual screening uptake between the control and intervention group were not significant (7% vs. 20%). Four percent of the intervention group and no one in the control group started treatment.



The small number of subjects should be considered when interpreting the results of this study. In brief, the single information session significantly improved HCV knowledge among PWUD, but did not result in a higher uptake for screening and treatment. This could signify that there are other important reasons, besides lack of knowledge, not to undergo screening or start treatment. The fact that knowledge decreased after 3months indicates that it would be beneficial to repeat the information session regularly.
Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium; Faculty of Medicine and Life Sciences, Universiteit Hasselt, Hasselt, Belgium. Electronic address: amber.arain@uhasselt.be.
Amber
A
Arain
Faculty of Medicine and Life Sciences, Universiteit Hasselt, Hasselt, Belgium.
Jessica
J
De Sousa
Faculty of Medicine and Life Sciences, Universiteit Hasselt, Hasselt, Belgium.
Kirsten
K
Corten
Medisch Sociaal Opvang Centrum, Genk, Belgium.
Rita
R
Verrando
I-BioStat, Universiteit Hasselt, Hasselt, Belgium.
Herbert
H
Thijs
Free Clinic, Antwerp, Belgium; Department of Public Health and Primary Care KU Leuven, Leuven, Belgium.
Catharina
C
Mathei
Department of General Practice, KU Leuven, Belgium and Maastricht University, The Netherlands.
Frank
F
Buntinx
Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium; Faculty of Medicine and Life Sciences, Universiteit Hasselt, Hasselt, Belgium; Department of Hepatology, University Hospitals KU Leuven, Leuven, Belgium.
Geert
G
Robaeys
D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006526:Hepatitis C / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010379:Peer Group; D010865:Pilot Projects; D016037:Single-Blind Method; D015819:Substance Abuse, Intravenous / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D013997:Time Factors
Hepatitis C virus; Knowledge; Persons who use drugs; Therapeutic education