Research Article of Open Journal of Gastroenterology and Hepatology
DEPIST’C PHARMA : An innovative outreach HCV screening project in pharmacy for general population
REMY Andre-Jean1, ALBERT Olivier2, PUGET Eric3, FONTAINE Sebastien1, H BOUCHIRA Hakim, HERVET Jeremy1, ROY Berengere1, HAPPIETTE Arnaud1
1Mobile Hepatitis Team, Perpignan Hospital, France; 2Pharmacy du Port, Port La Nouvelle, France; 3harmacy Poirotte, Perpignan, France
Background and Aims: Hepatitis C testing is still insufficient in France. Beyond defined groups with risk behaviors, hepatitis C testing should now be directed at the general population. The French pharmacies territorial coverage is excellent, and pharmacists are increasingly involved in public health actions (therapeutic education, vaccination against the flu). French Public Health Act on Innovation thank to the “Article 51” allow enables health care teams to propose experiments aimed at improving the diagnostic and/or therapeutic management of a disease. This funding methods and organization is unprecedented. Our aim was to screen for hepatitis C in pharmacies with POCT performed by pharmacists.
Methodology: Pharmacist recruitment was done on a voluntary basis from different pharmacies on a population pool of 600,000 inhabitants. Pharmacists received training and education appropriate to the POC testing. At request of the health authorities, screening was only proposed for patients with one or more risk factors (national health agency list). There were planned 10 tests per week per pharmacy over 12 months for a total of 5,000 tests. Expected prevalence was 10%. Patients with positive POCT were tested for HCV viral load real-time and for liver fibrosis assessment by FIBROSCAN. They could be treated with HCV antiviral direct agents.
Results: 37 pharmacists representing 32 pharmacies were trained to POCT use and announcement of results during 4 half days session. 9 pharmacies were located in agglomeration, including 5 in working-class areas, 7 in rural area, 7 in seaside area and 2 in middle mountain area. After 18 months of experimentation, 29 pharmacies have completed at least one POCT. We observed a decrease in the number of tests performed during the flu vaccination campaign and COVID pandemia and successive lockdowns; 547 tests were performed including 9 positives or a serological prevalence of 1.6%.; 7 patients had a negative viral load with 1 or 2 risk factors and a Fibroscan mean value at 4,5 KPa [fibrosis stage F1]; 2 patients had positive HCV viral load [prevalence 0.36%] and 3 to 9 HCV risk factors, mean Fibroscan value at 8.6 KPa [fibrosis stage F2]. They all were effectively treated and cured by direct antiviral agents.
Conclusion: We have demonstrated the feasibility of hepatitis C screening by POCT performed by pharmacists regardless of geographic location. Prevalence was similar as general population. Targeting screening by risk factors does not identify all patients. Pharmacists represent very interesting local healthcare professional who could invest in COVID19 screening by POCT.
Keywords: hepatitis C, screening, pharmacists, POCT
How to cite this article:
REMY Andre-Jean, ALBERT Olivier, PUGET Eric, FONTAINE Sebastien, H BOUCHIRA Hakim, HERVET Jeremy, ROY Berengere, HAPPIETTE Arnaud.DEPIST’C PHARMA : An innovative outreach HCV screening project in pharmacy for general population. Open Journal of Gastroenterology and Hepatology, 2023, 6:64. DOI: 10.28933/ojgh-2023-02-1005raj
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