PTU-097 The experience of methadone users in community pharmacy: a qualitative study to define the important attributes when designing a hepatitis C virus testing and treatment pathway

Abstract

Introduction Opioid replacement therapy (ORT) provided through community pharmacies is a public health service with major benefits. ORT patients have the highest rates of hepatitis C infection (HCV) and are the easiest to reach (i.e. they fetch their methadone every day from the pharmacy). However, these patients seem to have little interest in testing. Hence, a program that increases uptake of testing and treatment should have a major impact on patient health, reduce the spread of HCV, and be highly cost-effective. Service user perspectives are an important factor in enhancing value and utilisation. This study explored the experiences and perceptions of service users of community pharmacies, around provision of supervised self-administration of ORT and how they would obtain testing and treatment for HCV. Method A focus group methodology was chosen to identify the range of experiences and perceptions of service users. A topic guide was developed from evidence syntheses and refined through the study. Individuals were eligible for inclusion if they received ORT from a community pharmacy or were a carer. The study used a purposive sampling strategy to ensure a diversity of views were identified. Recruitment focussed on: Place of Residence –large urban/other urban/accessible small town Service Users Subject to Detention by the Criminal Justice System Perspectives of female service users Focus groups were digitally recorded and anonymised at transcription. Analysis drew on the constant comparison method in a general thematic approach. AR and KM developed a coding framework on the basis of the topic guide and initial analysis of transcripts. Results A pilot focus group and further 5 focus groups were undertaken, with 37 participants drawing on perspectives of service users and a small number of carers. Recurrent themes were identified of the experiences of service users: Issue of long waiting times; experiences of stigma; experiences of discrimination; issue of compromised confidentiality; experiences of good quality care provision; service users’ explanations for their experiences. Service Users’ understanding of HCV infection was based around: Perception of the disease; perception of the burden of treatment; preferences for obtaining treatment. Conclusion The eradication of HCV infection with new highly effective oral agents requires that much greater numbers of patients access testing and treatment. Community pharmacies offer the prospect of a hosting highly accessible testing and treatment in a local facility. In designing such a pathway it will be important to address the patients’ perceived obstacles to entering treatment Disclosure of interest None Declared.