IN SCOTLAND, 70 PER CENT OF PEOPLE AWARE OF THEIR INFECTION HAD ACCEPTED TREATMENT IN THE LATEST SURVEY PERIOD, UP FROM 28 PER CENT IN 2015-2016
Preventable bacterial infections remain a problem To prevent rates of bacterial infections increasing, provision of low threshold and outreach wound care services, as well as prompt treatment for injection site infections and tetanus vaccination is necessary. Furthermore, it is important for drug and alcohol services to facilitate safer injecting through enabling easy access to needle and syringe programmes (NSP) and embedding regular opportunities to discuss safe and hygienic injection practices with clients.
There has been no reduction in risk behaviours Continued sharing and re-use of injecting equipment remains a concern and the report recommends that a range of easily accessible services for all PWID, including NSP, should be provided in line with guidance.
‘Clients,’ it says, ‘should be supported to use low dead space equipment, including detachable needles and syringes that have lower dead space, to further reduce the risk of blood-borne virus
(BBV) and NSP should distribute enough injecting-related equipment to prevent sharing and re-use and support hygienic injecting practices.’
While he welcomes the report’s findings, Dr Andrew Radley, Consultant in Public Health Pharmacy at NHS Tayside, believes that there is still a lot of work to be done in this area and that community pharmacy can make a vital contribution.
‘The Shooting Up report provides us with a timely reminder that we have started to move towards the WHO Goal of eliminating Hepatitis C in Scotland, but there is still a lot of work to do. For Scotland, the data in the report is provided through the Needle Exchange Surveillance Initiative (NESI) and the Scottish Drugs Misuse Database. The Scottish Government has committed to effectively eliminate the virus by 2024, six years ahead of the World Health Organisation’s expectations.
‘For HCV, the data shows that the number of people who have chronic infection has continued to decline. This modest reduction is attributed to
the scale-up of treatment with the highly- effective Direct Acting Antiviral medicines. Underlying risk behaviours have not changed noticeably, and rates of new infections are unchanged. Around one in four of the population who inject drugs are still infected with HCV.
‘There is still a high proportion of individuals who have not had a recent test for HCV. To remove the burden of this disease from one of our most vulnerable populations, it is clear that people should be tested regularly. The report notes that it is of the utmost importance that testing services and care and treatment pathways are optimised to meet the needs of people who inject drugs.
‘Pharmacy has an unparalleled opportunity to contribute to the success of this work, both through the provision of opioid substitution therapy services and needle exchange services, which bring this population into daily contact with community pharmacies. The unique selling point of community pharmacy is its accessibility and its reach into our communities experiencing the greatest need.
‘Community pharmacists in Tayside have made a substantial contribution to the elimination of HCV across the region; the first place in the United Kingdom to achieve this. The SuperDOT-C study, undertaken in Tayside, Grampian and Glasgow, showed that community pharmacy teams could successfully carry out testing for blood-borne viruses, assess people with HCV infection for treatment and deliver a course of treatment to achieve a cure.’
PHARMACY HAS AN UNPARALLELED OPPORTUNITY TO CONTRIBUTE TO THE SUCCESS OF THIS WORK, BOTH THROUGH THE PROVISION OF OPIOID SUBSTITUTION THERAPY SERVICES AND NEEDLE EXCHANGE SERVICES
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