- Support health services to increase HCV treatment uptake in PWID using nurse-led models of care in primary care and prison services
- Assess the feasibility and impact of treating over 1,500 PWID annually in Victoria on prevalence and incidence of HCV in community and prison populations
- Inform HCV elimination models in Australia and globally
2016-2021
EC Victoria used a partnership approach involving researchers, healthcare providers, policy makers, community organisations and drug user networks. There were five main components of EC Victoria:
- Increase demand through health promotion, including funding community partner organisations Harm Reduction Victoria and Hepatitis Victoria/LiverWELL to develop new and improved health promotion resources, and convening a EC Health Promotion Working Group to coordinate community activities. This included Fitpack stickers and Be Free From C - Getting Treated on the Outside booklet produced by LiverWELL with support from EC Victoria and Hep C Treatment 'Ezy Card' Resource produced by Harm Reduction Victoria with support from EC Victoria
- Increase clinical capacity through training & education, including delivering education and training sessions and mentoring healthcare providers to increase testing and DAA prescribing, FibroScan training & certification program and loaning agreement to increase FibroScan access in regional Victoria, and producing a series of clinical resources including a toolkit to streamline clinical pathways
- Increase access to HCV testing & treatment through clinical support and streamlined clinical pathways in community and prison settings using nurse-led models: We partnered with 16 primary care services to implement enhanced HCV testing & treatment programs with EC nurses delivering a tailored package of support that included delivery of on-site pathology, point-of-care testing, incentives, FibroScans, treatment assessment and/or referrals and support to service staff to recall and follow up clients. Under the state-wide prison program led by St Vincent’s Hospital, EC Victoria supported the delivery of an HCV treatment program in 14 prisons, a trial of a care navigator program to link people released from prison into community based care and established a reporting mechanism for hepatitis C in prisons.
- Establish integrated HCV data and surveillance system to monitor trends in HCV prevalence and incidence over time, including expanding the ACCESS surveillance system to an additional 16 sites, and developing indicators to monitor the HCV care cascade at the service level
- Research and evaluation to trial new interventions to increase uptake of HCV testing & treatment, including a trial of rapid point-of-care testing (Rapid-EC), the EC Experience cohort to identify barriers and enablers to care, the Peer Assisting Treatment of Hepatitis C (PATH) project integrating peers into HCV models of care and the World Hepatitis Day 2019 campaign demonstrating the utility of incentives to reach new clients .
EC Victoria:
- Supported 16 primary care services to conduct 14,293 tests (antibody and RNA) and treat 1342 people
- Supported 14 prison sites to conduct 2465 clinical assessments and treat 1928 people
In total ~ 3,270 PWID were treated for HCV over five years.
Many of the lessons and learnings from EC Victoria were used to inform the design and implementation of the larger, national EC Australia Partnership, and findings from EC Victoria implementation and research projects influenced several national and global policy and guidelines.
Further evaluation of several of the EC Victoria components is underway, and will be used to inform ongoing HCV elimination efforts in Victoria and other jurisdictions.
Overall Project Materials
Health Promotion Related
- Fitpack stickers (available on LiverWELL site here) – produced by LiverWELL with support from EC Victoria
- Hep C Treatment 'Ezy Card' Resource (available on Harm Reduction Victoria site here) - produced by Harm Reduction Victoria with support from EC Victoria
- Be Free From C - Getting treated on the outside booklet (available on the LiverWELL site here) – produced by LiverWELL with support from EC Victoria
- Improving written health information - Checklist comparison (available here)
- Tailoring Hepatitis C Health Promotion for People Who Inject Drugs – poster presented at AVHEC 2019
- EC nursing model – poster presented at AVHEC 2019
- Upskilling hep C workforce presentation
- Practice software tools – several for each of Medical Director and Best Practice
Research Project: PATH
Prison Related
- Papaluca et al 2019 paper on treatment outcomes in prison (in press version here)
Funding
Partners
- NH&MRC partnership grant with Gilead Sciences
Partners +
Collaborators
- St Vincent’s Hospital, Department of Gastroenterology (Alex Thompson and team)
- Harm Reduction Victoria
- Hepatitis Victoria/LiverWELL
- Victorian Department of Health
- Justice Health Victoria
- Alfred Hospital
Project
Team
Meet the project team. Together, we are translating research into better health, for all.
Efunnuga H, Higgs P, Walker S, O'Keefe D
- Drug and alcohol review
- 09 Mar 2022
Gunn J, McNally S, Ryan J, Layton C, Bryant M, Walker S, O'Mahony C, Pedrana A
- The International journal on drug policy
- 28 Jul 2021
Chan K, Elsum I, Gold J, Layton C, Accadia L, Bryant M, Gunn J, Djordjevic F, Purcell I, Dicka J, Forrest M, Crawford S, Hellard M, Pedrana A, Eliminate Hepatitis C Partnership
- Journal of viral hepatitis
- 12 Dec 2020
Palmer A, Papaluca T, Stoové M, Winter R, Pedrana A, Hellard M, Wilson D, Thompson A, Scott N, EC Victoria Partnership
- The International journal on drug policy
- 18 Mar 2021
Traeger MW, Pedrana AE, van Santen DK, Doyle JS, Howell J, Thompson AJ, El-Hayek C, Asselin J, Polkinghorne V, Membrey D, Bramwell F, Carter A, Guy R, Stoové MA, Hellard ME, EC Victoria Partnership and the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of Blood-borne Viruses and Sexually Transmitted Infections (ACCESS)
- PloS one
- 30 Jun 2020
Papaluca T, McDonald L, Craigie A, Gibson A, Desmond P, Wong D, Winter R, Scott N, Howell J, Doyle J, Pedrana A, Lloyd A, Stoove M, Hellard M, Iser D, Thompson A
- Journal of hepatology
- 14 Jan 2019
Latham NH, Pedrana A, Doyle JS, Howell J, Williams B, Higgs P, Thompson AJ, Hellard ME
- Journal of viral hepatitis
- 01 Apr 2019
Williams B, Howell J, Doyle J, Thompson AJ, Draper B, Layton C, Latham N, Bramwell F, Membrey D, Mcpherson M, Roney J, Stoové M, Hellard ME, Pedrana A
- The International journal on drug policy
- 22 May 2019