P05 Treating children with HCV close to home through a virtual national multidisciplinary network

• Published in: Archives of disease in childhood 2023-05, Vol.108 (5), p.3-4
• Main Authors: Ahmed, Kinza, Crook, Joanne, Tennant, Alison, North-Lewis, Penny, Abbasi, Tayebah, Lloyd, Carla, Brown, Maxine, Kelly, Deirdre
• Format: Article
• Language: English
• Subjects: Abstract from the Neonatal and Paediatric Pharmacists Conference 2022; Antiviral agents; Antiviral drugs; Children; Clinical outcomes; Coronaviruses; Drug stores; Genotypes; Global health; Hepatitis; Hepatitis C; Networks; Outcomes of Treatment; Pandemics; Patients; Pediatrics; Pharmacists; Public health; Referral; Tablets
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2023-NPPG.5

AimHepatitis C Virus (HCV) infection is a major global health problem. Direct Acting Anti-viral therapy (DAA) has cure rates of 99% in adults and adolescents.1 DAAs were licensed for children 3 – 12 years during the recent coronavirus pandemic. In order to ensure equitable access and a safe, effective and convenient supply of these medications during lockdown, we established a virtual national treatment pathway for children with HCV in England and evaluated its feasibility, efficacy and treatment outcomes.MethodA paediatric Multidisciplinary Team Operational Delivery Network (pMDT ODN), supported by NHS England (NHSE), was established with relevant paediatric specialists, including pharmacists, to provide a single point of contact for referrals and information. Referral, treatment protocols and family friendly patient information were developed for all HCV therapy. On referral the pMDT ODN discussed and agreed the most appropriate DAA therapy based on clinical presentation and patient preferences, including ability to swallow tablets. Treatment was then prescribed and supplied in association with the local paediatrician and pharmacist, without the need for families to travel to national centres. All children were eligible for NHS funded therapy, each referring centre was approved by the pMDT ODN, prior to approval to dispense medication and funds were reclaimed via Blueteq authorisation. Demographic, clinical and social data was collected, and treatment outcomes were recorded. Feedback on feasibility and satisfaction on the pathway and supply of medication was sought from referrers.Results34 children were referred during the first six months; median (range) age 10 (3.9 – 14.5) years; 15M; 19F: Majority of referrals are HCV genotype type 1 (n=17) and 2 (n=12). DAA treatments prescribed: Sofosbuvir/Ledipasvir (n=21); Sofosbuvir/Velpatisvir (n=11) Glecaprevir/Pibrentasvir (n=2).27/34 confirmed as able to swallow tablets; 3/7 have received training and are now able to successfully swallow tablets; 4/7 are awaiting release of granules. All children who have completed treatment to date (11/27) have cleared virus at the end of treatment. Once the network was established, referrers found the virtual process easy to access. They valued being able to discuss their patients with the MDT providing a single point of contact with national specialists to discuss therapy. Specialist pharmacists within the pMDT were able to provide pharmaceutical information and support lo