Pharmacists working in all settings can play a ‘massive role’ in raising awareness of hepatitis C risks and testing, a leading pharmacist has said following the publication of a damning report into the decades-long infected blood scandal.
Dr Graham Stretch, president of the Primary Care Pharmacy Association (PCPA), told The Pharmacist that pharmacists should consider hepatitis C when a patient presented with hepatic symptoms, including unexplained weight loss, tiredness and jaundice, among others.
His comments follow the Infected Blood Inquiry’s report, published yesterday, which recommended GP practices should ask any new patients at registration whether they had a transfusion before 1996 and to offer patients who fall into that category ‘the opportunity of a precautionary blood test’ for hepatitis C.
Thousands of patients have died or ‘suffered miserably’ as a result of being treated with infected blood or blood products from the NHS, particularly in the years between 1970 and 1998, the inquiry found.
According to the report, around 26,800 people were infected with hepatitis C after a blood transfusion and around 1,250 people, including 380 children, were infected with HIV after being treated for bleeding disorders.
The most accurate estimate is that this led to more than 3,000 deaths, and the report puts the scandal down to a ‘catalogue of failures’.
As well as the ‘serious’ failures which led to infections, the report also finds that further failures – of health professionals to keep patients well informed and of the government to properly acknowledge wrongdoing – have ‘compounded’ suffering for the victims.
Sir Brian Langstaff, a former High Court judge and the inquiry’s chair, has made 12 recommendations for the government, the NHS and others based on his conclusions – with a ‘principal’ recommendation for the government to immediately set up a compensation scheme for victims.
In order to help find undiagnosed patients, he also recommends that GP practices ask any new patients at registration whether they had a transfusion before 1996.
This should be done ‘as a matter of routine’, and those patients who fall into that category should be ‘offered the opportunity of a precautionary blood test’ for Hepatitis C.
The report said: ‘There need be no alarm for the patient about this: rather, the offer should instil confidence that their safety is being protected by the doctor, and a substantial majority of previously untested patients may expect the reassurance of a negative test.
‘However, if the test is positive (as it is likely it will be in some cases) then treatment with direct acting antivirals may follow.’
This will raise ‘awareness’ about hepatitis C within general practice and ‘reduce the number of people diagnosed very late’, Sir Brian added.
Speaking to The Pharmacist following the report’s publication, Dr Stretch said pharmacists can play a ‘massive role’ in raising awareness of hepatitis C risks and testing.
Pharmacists working in all settings could consider hepatitis C when a patient presents with hepatic symptoms such as unexplained weight loss, tiredness, jaundice, abnormal liver function, memory and concentration issues and itchy skin, he said.
Dr Stretch added that patients may well mention these symptoms off-hand as part of a medicine review or in community pharmacy, which is often ‘people's first port of call’.
And ordering or referring for hepatitis C testing should particularly be considered for at-risk groups such as intravenous drug users or sex workers, he said.
Dr Stretch also reminded pharmacists about the importance of hepatitis C and HIV testing in the case of needlestick injuries during vaccinations, for both the patient and vaccinator.
In the Isle of Wight, pharmacy teams offering testing to users of a needle and syringe programme and opiate substitution therapy found several cases of hepatitis C over nine months.
And earlier this month, a nationally commissioned campaign ‘Hep C U Later’ made resources to encourage hepatitis C testing, including information, training and patient awareness posters available to community pharmacies.
Prime minister Rishi Sunak said yesterday that the publication of the report was a ‘day of shame for the British state’ and committed to paying ‘comprehensive compensation’ to victims.
A version of this article was first published by our sister title Pulse
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