Abstract
AIMS: Belfast Trust Addictions Service was among the first addictions teams in the UK to get their own Fibroscan® machine, in March 2021. In the two preceding years (2019–2020), only 32% of patients referred by addictions to hepatology for hepatitis C virus (HCV) attended their appointments. Patients under the addictions service are known to access healthcare services poorly while being at increased risk, with a clear need to improve their access to appropriate care. We aimed to review how the Fibroscan® machine has been used in the addictions service, and if there has been an impact on how the patient cohort access healthcare. METHODS: We reviewed our case records of all patients offered a Fibroscan®, and whether they attended the appointment, and reviewed indications of each scan in the three following categories. Firstly, for those with alcohol misuse. Secondly, for HCV cases in which Fibroscan® results help decide treatment choice. Thirdly, ‘other’ – for example, consultant discretion due to LFT results. RESULTS: 308 patients were offered Fibroscans® between March 2021 and February 2023. 238 patients attended their appointments, of which 194 were for alcohol misuse, 43 for HCV and 1 ‘other’. 70 patients did not attend their appointments, of which 67 were for alcohol misuse and 3 ‘other’. Scans for HCV were completed ad hoc (i.e. without an arranged appointment) so are not included in attendance rates. The attendance rate for scheduled Fibroscan® appointments (for alcohol misuse and ‘other’) was 74%. Of the 194 patients scanned for alcohol misuse, 40 were then referred to hepatology with likely cirrhosis. CONCLUSION: 238 patients underwent a Fibroscan®, leading to 40 hepatology referrals for likely cirrhosis, and 43 patients being offered appropriate HCV treatment. Crude DNA rates appear greatly improved – 74% attendance at our Fibroscan® appointments vs 32% attendance at hepatology referral appointments.