{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T07:50:24Z","timestamp":1769068224162,"version":"3.49.0"},"reference-count":46,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T00:00:00Z","timestamp":1680825600000},"content-version":"unspecified","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Cepheid UK Ltd","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,3,29]]},"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Hepatitis C virus (HCV) poses a global public health threat. Prisons are a focus of prevention efforts due to high infection burdens. Expedition of treatment for incarcerated people is critical, as many are short-term sentenced. We evaluated point-of-care (PoC) HCV RNA testing in a maximum-security Scottish prison and assessed its impact on transition to treatment. We also evaluated costs and determinants of implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Mixed-methods evaluation of a single-centre care pathway pilot using National Health Service (NHS) data from 2018 to 2021. Descriptive statistics and survival analysis were undertaken. Cost analysis was assessed from a provider perspective. Healthcare staff participated in semistructured interviews and thematic analysis with a deductive approach was undertaken to identify implementation determinants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A large maximum-security Scottish prison health centre administered by the NHS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>296 incarcerated NHS patients (all men) and six NHS staff members (two men and four women).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>HCV testing using the Cepheid GeneXpert platform with Xpert HCV VL Fingerstick assay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>The main outcome was survival (in days) from HCV test to treatment initiation. Secondary outcomes were cost-per-cure obtained and implementation determinants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the pilot, 167 Xpert tests were administered, with an 84% completion rate, and treatment transition was superior for those who received it (p=0.014). Where PoC tests were administered, shorter survival to treatment was observed (19 vs 33 days: adjusted HR (aHR) 1.91 (1.03\u20133.55), p=0.040; 19 vs 50 days; aHR 3.76 (1.67\u20138.46), p=0.001). PoC was costlier than conventional testing. In qualitative analysis, most facilitators were observed among characteristics of individual domain while most barriers were noted in the inner setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Integrating PoC HCV RNA diagnosis into nurse-led HCV care in a maximum-security prison health centre shortens survival to HCV treatment. However, there are cost implications to this approach and multiple determinants that impact on implementation should be addressed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-068604","type":"journal-article","created":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T14:30:11Z","timestamp":1681137011000},"page":"e068604","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Mixed-methods evaluation of point-of-care hepatitis C virus RNA testing in a Scottish prison"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7586-7712","authenticated-orcid":false,"given":"Christopher J","family":"Byrne","sequence":"first","affiliation":[{"name":"Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK"},{"name":"Directorate of Public Health, NHS Tayside, Dundee, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Malaguti","sequence":"additional","affiliation":[{"name":"Tayside Drug and Alcohol Recovery Psychology Service, NHS Tayside, Dundee, UK"},{"name":"Department of Psychology, University of Dundee, Dundee, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah Karen","family":"Inglis","sequence":"additional","affiliation":[{"name":"Tayside Clinical Trials Unit, University of Dundee, Dundee, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John F","family":"Dillon","sequence":"additional","affiliation":[{"name":"Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK"},{"name":"Department of Gastroenterology, NHS Tayside, Dundee, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,4,10]]},"reference":[{"key":"2025121222183588000_13.4.e068604.1","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1111\/jvh.13428","article-title":"Progress towards micro-elimination of hepatitis C in the custodial setting","volume":"28","author":"Gallacher","year":"2021","journal-title":"J Viral Hepat"},{"key":"2025121222183588000_13.4.e068604.2","doi-asserted-by":"crossref","first-page":"e1192","DOI":"10.1016\/S2214-109X(17)30375-3","article-title":"Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review","volume":"5","author":"Degenhardt","year":"2017","journal-title":"Lancet Glob Health"},{"key":"2025121222183588000_13.4.e068604.3","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.drugpo.2018.04.003","article-title":"Interventions to increase testing, linkage to care and treatment of hepatitis C virus (HCV) infection among people in prisons: a systematic review","volume":"57","author":"Kronfli","year":"2018","journal-title":"Int J Drug Policy"},{"key":"2025121222183588000_13.4.e068604.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30856-X"},{"key":"2025121222183588000_13.4.e068604.5","doi-asserted-by":"publisher","DOI":"10.1111\/add.12107"},{"key":"2025121222183588000_13.4.e068604.6","unstructured":"Scottish Public Health Observatory . 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