Improving engagement with healthcare in hepatitis C: A randomised controlled trial of a peer support intervention

Helen R. Stagg*, Julian Surey, Marie Francis, Jennifer MacLellan, Graham R. Foster, André Charlett, Ibrahim Abubakar

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)

Abstract

Background: Peer support can enable patient engagement with healthcare services, particularly for marginalised populations. In this randomised controlled trial, the efficacy of a peer support intervention at promoting successful engagement with clinical services for chronic hepatitis C was assessed. Methods: In London, UK, potential participants were approached through outreach services for problematic drug use and homelessness. Individuals positive for hepatitis C virus (HCV) after confirmatory testing were randomised using an online service to the intervention (peer support) or standard of care. The primary outcome of interest was successful engagement with clinical hepatitis services. The study was non-blinded. Absolute differences were calculated using a generalised linear model and the results compared to logistic regression. Results: Three hundred sixty-four individuals consented to participate. One hundred one had chronic hepatitis C and were randomised, 63 to receive the intervention (peer support). A successful outcome was achieved by 23 individuals in this arm (36.5%) and seven (18.4%) receiving the standard of care, giving an absolute increase of 18.1% (95% confidence interval 1.0-35.2%, p value = 0.04). This was mirrored in the logistic regression (odds ratio 2.55 (0.97-6.70), p = 0.06). No serious adverse events were reported. Conclusions: Peer support can improve the engagement of patients with chronic HCV with healthcare services.

Original languageEnglish
Article number71
JournalBMC Medicine
Volume17
Issue number1
DOIs
Publication statusPublished - 1 Apr 2019

Bibliographical note

Funding Information:
This report is independent research funded by the National Institute for Health Research Policy Research Programme (‘Effectiveness of testing for treatment of hard-to-reach groups for latent tuberculosis, hepatitis B virus and hepatitis C virus in England: The HALT Study’, 015/0306). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care. The study funders and sponsor had no role in the design of the study; the collection, analysis, and interpretation of the data; in the writing of the paper; and in the decision to submit it for publication.

Funding Information:
HRS reports funding from the Department of Health during the course of the study. JS, JM and MF report funding from the Department of Health and the National Institute for Health Research Clinical Research Network, UK, during the conduct of the study. GF reports personal fees from AbbVie, Gilead and Merck during the conduct of the study. The other authors declare that they have no competing interests.

Publisher Copyright:
© 2019 The Author(s).

Keywords

  • Hepatitis C
  • Peer advocacy
  • Peer support
  • Peer worker

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