The prevalence of viral hepatitis among people in prisons is higher than in the general population. Screening, treatment and vaccination programmes exist within prisons to reduce the incidence of hepatitis, although lower uptake has often been reported compared to similar programmes outside of prisons. We conducted a systematic review of qualitative evidence to explore the barriers and facilitators to hepatitis B and C reduction programmes in prisons from the perspectives of people in prison, custodial staff and prison healthcare staff.
View Article and Find Full Text PDFCirrhosis represents a major cause of morbidity and mortality, leading to a marked impairment in the quality of life of patients and their caregivers, and resulting in a major burden on healthcare systems. Currently, in most countries, nurses still play a limited role in the care of patients with cirrhosis, which is mainly restricted to the care of patients hospitalised for acute complications of the disease. The current manuscript reviews the established and potential new and innovative roles that nurses can play in the care of patients with cirrhosis.
View Article and Find Full Text PDFThe COVID-19 pandemic has resulted in significant delays to non-urgent elective surgery. Decision making regarding prioritisation for surgery is currently informed primarily by clinical urgency. The ways in which decision making should also consider potential social and economic harm arising from surgical delay are currently unclear.
View Article and Find Full Text PDFNon-alcoholic fatty liver disease (NAFLD) is common, affecting approximately 25% of the general population. The evidence base for the investigation and management of NAFLD is large and growing, but there is currently little practical guidance to support development of services and delivery of care. To address this, we produced a series of evidence-based quality standard recommendations for the management of NAFLD, with the aim of improving patient care.
View Article and Find Full Text PDFBackground: The World Health Organization's aim to eliminate hepatitis C virus (HCV) infection as a public health threat by 2030 is dependent on testing people. HCV prevalence is higher in prisons, so to increase test uptake an 'opt-out' approach to blood-borne virus testing in English and Welsh prisons was introduced.
Aims: This literature review examines the evidence behind the introduction of this public health policy.
The use of person-centred language is well accepted regarding substance use and infectious disease healthcare and research, and appropriate acronyms have become commonplace, e.g., "people who inject drugs (PWID)" has mostly replaced phrases like "injecting drugs users".
View Article and Find Full Text PDFBackground: Realist evaluation is increasingly used in healthcare research, and theories can provide plausible explanations of why interventions work or do not work in certain circumstances such as the effect of the opt-out hepatitis C virus (HCV) testing policy in English prisons.
Aim: To present the process of constructing the middle-range theories (MRTs) developed as part of an evaluation of hepatitis C test uptake in an English prison as a resource for researchers using realist evaluation.
Discussion: MRTs are propositions that can explain a particular behaviour or outcome.
The target set by the World Health Organization to eliminate viral hepatitis as a public health problem by 2030 first requires methods of testing for hepatitis B and C virus that are acceptable to diverse populations. One such test is the dried blood spot sample method. This article explains what a dried blood spot sample is, how it is collected, and how it can help increase the viral hepatitis test uptake in prisons, drug and alcohol services, and other populations at risk of hepatitis B or C infection.
View Article and Find Full Text PDFThe prison population is central to the campaign to eliminate hepatitis C virus as a public health threat. In the UK, this has led to the introduction of a national 'opt-out' policy, requiring people in prison to be tested for HCV unless they decline, with a target to test 75% of those admitted. However, in a representative prison estate in the East Midlands of England (20,000 prison entrants per annum) testing rates were only 13.
View Article and Find Full Text PDFPrisons are a key demographic in the drive to eradicate hepatitis C virus (HCV) as a major public health threat. We have assessed the impact of the recently introduced national opt-out policy on the current status of HCV testing in 14 prisons in the East Midlands (UK). We analysed testing rates pre- and post-introduction of opt-out testing, together with face-to-face interviews with prison healthcare and management staff in each prison.
View Article and Find Full Text PDFAims And Objectives: To explore the views of prison officers in an English category B male prison about people in prison being tested and treated for hepatitis C.
Background: Hepatitis C testing and treatment in English prisons remain low with the reasons being poorly understood. Prison officers are in continuous contact with prisoners so might observe factors that may influence people in prisons' choice in whether to accept hepatitis C testing and treatment.