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Understanding barriers and facilitators to the take up of new direct-acting antiviral hepatitis C treatments: The Observe Study

The Observe Study collected information during 2017 and 2018 from people who inject drugs (PWID) about their experiences with new direct-acting antiviral (DAA) treatments for hepatitis C to learn more about their perspectives and experiences of the factors that support or prevent uptake of these treatments. The study collected quantitative and qualitative data from people attending needle and syringe programs (NSP) in metropolitan and regional NSW to examine:

• the take-up of treatment, pathways and experiences through the care system, and individual, social and systemic reasons for taking up treatment
• for those who do not take up treatment, the range of reasons for not doing so and the individual, social and systemic factors associated with declining treatment, including their opportunities for treatment and experiences with the care system.

The study used a mixed-method longitudinal design. 293 participants completed a survey. Of these, n=155 or 53 per cent were ineligible for DAA treatment because they were hepatitis C negative, did not know their status, or had cleared the virus previously with interferon treatments. Of the remaining n=138 who were eligible to take up treatment, n=82 had already done so (60 per cent) and an additional n=56 had not. Sixteen participants took part in an in-depth interview. Of these, seven had begun DAA treatment and nine had not. These 16 interview participants comprised of three women and 13 men and ranged in age from 27 to 62 years, with most (n=9) aged in their 30s and 40s.

We undertook a small qualitative key stakeholder study in southern and western areas of NSW to explore the pathways to and experience of DAA treatment in these settings. Of the 23 interviews collected for this component of the study, 16 were with service users and seven were from professional stakeholders. Of the 16 service users, eight identified as female and eight male and they ranged in age from 23 to 54yrs. Five had not started DAA treatment and 11 had. The professional stakeholders were clinical staff, including nurses (three), managers (two) and pharmacists (two).Ìý