Innovative service is tackling silent killer among us
10th February 2012
Liver disease is the fifth largest cause of death in the UK but the majority of liver disease is undiagnosed and untreated. Hepatitis C is one of these.
In response to high prevalence rates of Hepatitis C in their patients, Brownlow Health has set up a special service to screen and treat patients in the community.
The service, which is now in its second year, is the first primary care led treatment service of its kind in the country, and has just been awarded Innovator of the Year at the General Practice Awards.
So far, the service has assessed approximately 300 patients and more than 200 were found to be carrying Hepatitis C. Treating the condition in the community is cost effective and is saving the NHS money.
Jayne Wilkie is the Hepatitis C Specialist Nurse who runs the service for patients. Her role involves raising awareness with GPs so that patients who may have been at risk of contracting Hepatitis C can be identified; screening patients and where possible, managing their treatment in the community.
She explains: “Brownlow Practice has 26,000 patients, which includes a large student population; patients with drug and alcohol patients; homeless patients and sex workers. This service was set up in response to a number of our patients being found to have been at risk of contracting Hepatitis C or being found to have contracted it.
“We are also aware that many patients with this condition live extremely chaotic lives and it can often be tricky to assess and treat them in hospital settings because they find it difficult to attend appointments. Our patients find it easier to attend appointments in the community because we can offer them more flexibility, and we already have a relationship with them.”
Unfortunately symptoms for Hepatitis C are very uncommon. Often it is only when the liver starts to fail with cirrhosis that symptoms appear. It is a blood to blood bourne virus, which means it can only be transmitted via blood. This could be done by the sharing any drug paraphernalia – the most common way is the sharing of needles. Other methods of transmitting the virus include people who received blood transfusions prior to 1991, and via tattoos, piercings and dental work but these are far less common. You are more at risk if this was undertaken abroad.
Jayne adds: “If left untreated patients infected with the virus are at risk of developing cirrhosis of the liver, which also puts you at an increased risk of developing liver cancer. We strongly believe that treating patients in the community is leading to earlier diagnosis and is preventing patients from developing more severe liver conditions. It also means we can support them through treatment, as it can often be lengthy and harsh for patients. Many of them have no support networks so we have set up a support group.
“The support group is open to anyone who has Hepatitis C, and needs adverse treatment. We provide support to patients and their families and friends, whilst they are receiving treatment or after their treatment has been completed. We find the service is working really well and the response we have had from patients has been very positive.”
CASE STUDY
A former drug addict is urging patients who may have put themselves at risk of contracting Hepatitis C to go and get tested and seek treatment if necessary.
Tom O’Brien, 50, is a patient of Brownlow Health and lives in the city centre. He had the disease for 15 years without diagnosis.
He said: “I think I had Hepatitis C for about 15 years without realising I had it. There are no symptoms so unless you go and get tested you would never know you had it. I think I probably contacted the virus from injecting drugs when I was younger. At the time I obviously was not aware of or considered the risks.
“I would say to anyone who thinks they may have put themselves at risk, to go and get tested. I was lucky because there has been no permanent damage to my liver as a result of contracting Hepatitis C.”
After being diagnosed with the virus, Tom was given a liver scan as Hepatitis C can result in scarring to the liver. The Fibroscan is a non-invasive and painless test that measures how stiff the liver is. It helps to detect any signs of damage that will need further investigation.
Tom continued: “My treatment involved weekly injections, which I received at my GP practice. I think it was great that I could be treated within the community and for me, already having a relationship with Brownlow and with my nurse Jayne was very important in my decision to go forward with the treatment. Although I wanted to get rid of the Hepatitis C, if I had to go to hospital for treatment, there is no way I would have gone.
“The treatment was tough. I lost two stone very quickly as it affects your appetite but because Jayne was monitoring me she was able to explain that weight-loss was a side-effect and gave me supplement drinks to try and reduce the amount of weight I was losing. I really struggled with the treatment but with the support of Jayne and my partner, I kept going. I was very lucky to have constant support but I know some patients go through this treatment alone, which is why I think the support group is such a good idea.” (The support group is run at St Stephens Church on Crown Street on the first Wednesday evening of every month.)
“Six weeks after my treatment was complete, I felt much better and the side-effects calmed down. I had to receive treatment for six months altogether and I completed it five months ago. Next month I find out if I am clear of Hepatitis C but early tests show I am.
“Part of the reason I wanted to go for treatment is because I didn’t want to be worrying about being ill from liver problems in the future but it is also about putting the past behind me. I have been clean for two and half years now, and getting rid of the Hepatitis C is the last step in completely leaving that behind me. I would say to anyone who thinks they may have contracted it, to go and get the test. The treatment is tough but the end results are definitely worth it.”
