Role of peer support in a hepatitis C elimination programme

Area of Science:

• Hepatology
• Public Health
• Health Services Research

Background:

• Chronic hepatitis C infection affects many individuals, yet treatment engagement remains low.
• Eliminating hepatitis C and reducing health inequalities necessitates universal access to therapy.
• Peer support has shown benefits in other conditions, but its impact on hepatitis C care is less clear.

Purpose of the Study:

• To evaluate the effectiveness of peer support in hepatitis C treatment networks.
• To compare treatment outcomes between networks with and without peer supporters.
• To identify specific areas where peer involvement may influence patient care and treatment adherence.

Main Methods:

• Retrospective analysis of the English National Health Service treatment registry.
• Comparison of 20 operational delivery networks, stratified by the presence or absence of peer supporters.
• Bayesian Poisson and Binomial mixed-effects models were used to analyze count and proportion outcomes, respectively, controlling for time effects.

Main Results:

• Networks with peer supporters showed a significant increase in therapy initiation (RR 1.12, 95% CI 1.02-1.21) and completion (OR 2.45, 95% CI 1.49-3.84).
• No significant changes were observed in therapy initiation among people who use drugs or in virological response rates.
• An increase in treatment proportion within addiction services was noted after peer supporters were established.

Conclusions:

• Inclusion of peer supporters in chronic hepatitis C treatment programs can enhance patient engagement.
• Peer support appears to positively influence the initiation and completion of antiviral therapy.
• Further research may be warranted to optimize peer support strategies for specific patient populations and outcomes.