My name is Nicola Speers and I am a speciality doctor in addictions psychiatry in Belfast. I have been serving opiate dependant patients as part of the multidisciplinary team in the Substitute Prescribing Team in the Belfast Health and Social Care Trust for the last 2 years. Prior to this I was a GP trainee in Belfast.
Our service saw a significant fall in face to face patient contact during the first wave of the COVID-19 pandemic. This audit sought to assess the impact this had on our performance in achieving blood virus testing and hepatitis B vaccination for both new and existing patients and to take the opportunity to address this when face to face services resumed.
Audit of blood borne virus testing and hepatitis B vaccination within the Belfast Trust Substitute Prescribing Service
Rates of blood borne viruses (BBVs) are high among people who inject drugs (PWID). Vaccination provides protection against hepatitis B virus (HBV). BBV testing is the first step to accessing treatment. Orange Guidelines encourage focus on ongoing and emerging risk. Aim to assess rates of HBV vaccination, BBV testing and engagement with appropriate treatment services for those testing positive within our service and to compare this with national rates. Retrospective re-audit of all patients in treatment with our service at time of data collection (total 248). Chart reviewed for whether BBV testing been offered and completed, the date of completion and results. Referral to or engagement with the appropriate service checked for BBV. We checked whether HBV vaccination was offered and completed. The data was collated, analysed, and presented at our addictions academic meeting. 97.98% were offered vaccination. 59.27% had partial completion of schedule. 99.2% had BBV testing offered. 93.5% had BBV testing performed. 65.3% was within the last 12 months. Of BBV results available, 52.1% were negative for all, 47.9% had previous HCV exposure, 27.4% had HCV active infection, 0.9% were HBV exposed and 2.7% had HIV infection. All patients infected with HIV were engaged with the appropriate service. For HCV exposed patients, 41% were undergoing or completed treatment. Among those with antiHCV, prevalence of HCV RNA was lower in the UAM survey 2019 (42%) compared with our service population (57%). Vaccination rates and communication with other services and access to HCV treatment were identified as areas for improvement.