P178 Structured re-engagement project: a smartphone-based initiative to improve engagement for patients with untreated HCV

<h3>Background and Aims</h3> Individuals living with hepatitis C virus (HCV) may experience barriers accessing treatment including constrained resources, lack of means of communication and negative healthcare experiences. This study evaluates use of smartphones and peer support to improve engagement with HCV treatment. <h3>Method</h3> In this peer-led structured support intervention, patients with HCV deemed the most challenging to engage were offered a smartphone and 2-year contract, peer support and bespoke social support. Eligibility criteria included those delayed longest from diagnosis to treatment, patients leaving prison without a phone, and those considered highest risk of disengagement by our outreach team. The smartphone contract was terminated if the participant was uncontactable; replacement phones were offered to those demonstrating engagement. Engagement and treatment outcome data was collected, patient satisfaction was assessed via survey. <h3>Results</h3> 47 participants were enrolled over 18 months. Year of diagnosis ranged from 1999–2023; 43% were delayed for ≥5 years from diagnosis and nearly 1/3 had previously failed treatment. Following the intervention, 46 (98%) patients started treatment, 39 (83%) within one month of receiving the smartphone. Of those with sufficient time to do so, 32 out of 45 (71%) participants completed treatment. 13 out of 18 (72%) participants with adequate time who were delayed ≥5 years completed treatment. 10 out of 15 (67%) participants who had previously failed treatment completed treatment. Overall, 24 (65%) participants who were enrolled with enough time to achieve cure of HCV were successfully treated. At study completion, 29 (62%) patients had an active handset. 81% of those who had a phone at the end completed a course of treatment and 56% who did not have a phone at the end completed treatment. Participants who completed the survey rated the project’s helpfulness an average of 9/10 in supporting their treatment; all agreed that it improved their wellbeing. <h3>Conclusion</h3> This intervention has had a significant positive impact on patients considered the most difficult to engage. Although unable to match a group with similar barriers who did not have a phone, there is clear benefit with most patients maintaining engagement with treatment. Those delayed ≥5 years from diagnosis represent a particularly disengaged subgroup and a high proportion completed treatment. Each smartphone and contract costs £326.35. Given that cost of untreated HCV includes the burden of managing advanced liver disease, earlier deaths and societal impacts¹, we propose that this is a cost saving initiative warranting further health economic analysis.