Optimising the implementation of community pharmacy based testing for hepatitis c: delphi consensus statement

Background

The World Health Organisation aims to eliminate Hepatitis C (HCV) by 2030. To achieve this, targeted testing needs to be widely available. Studies have demonstrated that community pharmacies can deliver effective targeted testing for HCV and the National Health Service in England has commissioned a national service. A recent survey of HCV operational delivery networks has shown limited uptake of this service.

Objective

To form a consensus statement to guide the widespread implementation of community pharmacy-based targeted testing for HCV.

Method

We used a modified Delphi method. A purposive selection of panel experts was identified and recruited from a national survey and via chain-referral sampling. The main inclusion criteria for selection were direct involvement in the implementation of an HCV testing service in pharmacies. We conducted a three round Delphi (figure 1). The first round was analysed using thematic analysis with a framework method based on the WHO Health Systems Framework; this generated statements that were assessed for consensus in rounds 2 and 3.

Results

Twenty-four experts were selected for the Delphi. This included: 7 clinicians, 3 pharmacists, 2 peers, 2 nurses and 3 local pharmaceutical committee leads. All 24 (100%) completed rounds 1 and 2 and 23 (96%) completed round 3. Fifty-six statements were agreed after Round 3. These related to service delivery, communication and engagement, workforce, health information systems, medical procurement, and financing. Statements relating to the use of ‘Peers’ to engage at risk pharmacy clients and the need for strong links between pharmacies and local treatment services were strongly supported.

Conclusion

The findings from this Delphi consensus study will support the widespread implementation of targeted testing for HCV in community pharmacies.