Research and Technology

27.02.20

First UK clinical trial to identify, assess and treat hepatitis C patients found to be effective

A University of Bristol-led clinical trial to increase the identification and treatment of hepatitis C (HCV) patients in primary care has found to be effective, acceptable to staff and highly cost-effective for the NHS.

Publishing their findings from the study in the British Medical Journal, researchers working on the Hepatitis C Assessment to Treatment Trial (HepCATT) provided robus evidence of effective action GPs should take to increase HCV testing and treatment.

The National Institute for Health Research (NIHR)-funded trial assessed whether a multi-part intervention in GP practices could increase the identification and treatment of HCV-infected patients compared to usual care. The clinical trial took place in south west England, with 22 practices randomised to intervention and 23 to the control arm.

Flagging patients with HCV risk markers through a newly-devised electronic algorithm, they were then invited in for an HCV test by letter or opportunistically through pop-up messages during consultations. Practice staff received HCV educational training and HCV posters and leaflets were placed in waiting rooms to increase awareness among patients.

As part of the new algorithm, around 5% of all patients were flagged with HCV risk markers, and of the flagged patients tested for HCV there was a 59% increase in testing at HepCATT intervention practices compared with the control practices. Five times as many patients were assessed for treatment in HepCATT intervention practices.

Intervention of this nature was comparatively low cost at an average of £624 per general practice and £3,165 per additional patient assessed at hepatology. Extrapolating the full cost, taking into account future reduction in chronic illness, saw the overall benefit estimated to be £6,212 per Quality Adjusted Life Year (QALY), well below the average cost of an intervention in the NHS and the National Institute for Health and Care Excellence (NICE) threshold for recommending interventions of £20,000 per QALY.

READ MORE: NHSE strikes largest ever deal to ‘completely eliminate’ hepatitis C

READ MORE: Needlestick; The harms and cost of an avoidable injury

Matt Hickman, Professor in Public Health and Epidemiology and co-Director of NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol, who led the study, said: “We know that scaling up hepatitis C case-finding and treatment alongside interventions that minimise transmission among people who inject drugs is critical for long-term prevention of chronic hepatitis C and hepatitis C-related disease and mortality.

“The HepCATT intervention had a modest impact but was highly cost-effective. We therefore recommend that it is considered for roll-out across the NHS, with further refinement and improvement before widescale implementation.”

Dr Sema Mandal, Medical Consultant Epidemiologist Lead for Hepatitis at Public Health England, added: “With nearly 100,000 people living with hepatitis C without a diagnosis it’s vital that we optimise and implement new ways to enhance case finding in primary care.

“This new approach not only increases testing but ensures more people access life-saving treatments. Public Health England is working with NHS England and partners across academia to eliminate hepatitis C as a major public health threat and this new approach will help accelerate these efforts.”

Across the UK, around 143,000 people have chronic HCV infection, with 85% of those having a history of injecting drugs.

As symptoms do not present themselves for several years, less than half of people infected are aware they have HCV and many more do not receive treatment, increasing the risk of liver damage and passing the virus to others.

The National Institute for Health and Care Excellence (NICE) in England recommends that GPs should increase testing and treatment, especially among people who inject drugs. However, robust evidence of effective interventions is lacking at present and testing and treatment rates in many sites are low.

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

NHS Business Services Authority: ‘We are the NHS supporting the NHS’

31/03/2020NHS Business Services Authority: ‘We are the NHS supporting the NHS’

With the ongoing coronavirus outbreak demanding significant time and care from the NHS, it has become vitally important for all aspects of the he... more >
Zappshelter: ‘It’s about supporting the country in a time of need’

31/03/2020Zappshelter: ‘It’s about supporting the country in a time of need’

[Sponsored Content] In light of the ongoing coronavirus outbreak, workforces have seen a need to keep people separated on sites, with specia... more >
NHSCFA: Never get bored of fraud

31/03/2020NHSCFA: Never get bored of fraud

Matthew Jordan-Boyd, Director of Finance & Corporate Governance, NHS Counter Fraud Authority (NHSCFA) I have written several articles ab... more >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital exemplars who were revealed at the same show 12 months earlier.  Jeremy Hunt also stated th... read more >

last word

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad, president of the Association of the British Pharmaceutical Industry (ABPI), sits down with National Health Executive as part of our Last Word Q&A series. Would you talk us th... more > more last word articles >

the scalpel's daily blog

NHSCFA: Never get bored of fraud

31/03/2020NHSCFA: Never get bored of fraud

Matthew Jordan-Boyd, Director of Finance & Corporate Governance, NHS Counter Fraud Authority (NHSCFA) I have written several articles about the work of NHSCFA and that tends to be from my fairly technical angle as a figures person, an accountant who has worked in the NHS for almost 20 years. When I discuss the need to be more vig... more >
read more blog posts from 'the scalpel' >

comment

NHS England dementia director prescribes rugby for mental health and dementia patients

23/09/2019NHS England dementia director prescribes rugby for mental health and dementia patients

Reason to celebrate as NHS says watching rugby can be good for your mental health and wellbeing. As the best rugby players in the world repr... more >
Peter Kyle MP: It’s time to say thank you this Public Service Day

21/06/2019Peter Kyle MP: It’s time to say thank you this Public Service Day

Taking time to say thank you is one of the hidden pillars of a society. Being on the receiving end of some “thanks” can make communit... more >
Nurses named as least-appreciated public sector workers

13/06/2019Nurses named as least-appreciated public sector workers

Nurses have been named as the most under-appreciated public sector professionals as new research reveals how shockingly under-vauled our NHS, edu... more >
Creating the Cardigan integrated care centre

10/06/2019Creating the Cardigan integrated care centre

Peter Skitt, county director and commissioner for Ceredigion Hywel Dda University Health Board, looks ahead to the new integrated care centre bei... more >

interviews

Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

24/10/2019Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

Today, speaking at the Royal College of General Practitioners (RCGP) annual conference, Matt Hancock highlighted what he believes to be the three... more >
NHS dreams come true for Teesside domestic

17/09/2019NHS dreams come true for Teesside domestic

Over 20 years ago, a Teesside hospital cleaner put down her mop and took steps towards her midwifery dreams. Lisa Payne has been delivering ... more >
How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >

health service focus

View all News