Non-attendance at drug service Hepatitis C outreach clinics: clients and staff experiences.
type: CreativeWork
description: Non-attendance in the drug service hepatitis C outreach clinic means clients miss essential components of care: being offered lifestyle advice such as limiting their alcohol intake (to prevent further progression of liver disease);a discussion about ways to avoid transmission to others; and referral for hospital treatment, which can be curative. In the absence of much empirical evidence many suggestions have been given for missed appointments by hepatitis C patients. For example, they forget, lead ‘chaotic lifestyles’, the infection is ‘not a priority’ to them and they are ‘hard-to-reach’. This study was undertaken to investigate beneath these ‘surface’ reasons for non-attendance. Thus, a realist approach was taken. The study comprised three phases of theory development and testing that incorporated qualitative telephone interviews with clients followed by a national survey of staff. All 28 clients who participated gave ‘surface’ or ‘prima-facie’ reasons for non-attendance. However, the study revealed hidden underlying factors (mechanisms). These were categorised under the themes: (i) ‘client characteristics’ e.g. ‘priority’ to score drugs and the ‘cost of travel’ (ii) ‘hepatitis C’ e.g. ‘no symptoms’ and fear of treatment ‘side-effects’ (iii) ‘clinic service’ e.g. ‘distance’ to the clinic and difficulty with ‘reimbursement’ of travel expenses. These mechanisms were produced within a complex context of factors including addiction, welfare policy and stigma. They were often played out in different ways and linked to other mechanisms. 41 out of 142 (29%) drug services in England ran a hepatitis C outreach clinic. There was general agreement with clients about reasons for nonattendance. However, there was some discordance, notably difficulty with walking. This study revealed a complex picture for non-attendance in a hepatitis C outreach clinic and makes an original contribution to knowledge about the reasons for missed appointments. This in turn has informed changes to…
abstract: Non-attendance in the drug service hepatitis C outreach clinic means clients miss essential components of care: being offered lifestyle advice such as limiting their alcohol intake (to prevent further progression of liver disease);a discussion about ways to avoid transmission to others; and referral for hospital treatment, which can be curative. In the absence of much empirical evidence many suggestions have been given for missed appointments by hepatitis C patients. For example, they forget, lead ‘chaotic lifestyles’, the infection is ‘not a priority’ to them and they are ‘hard-to-reach’. This study was undertaken to investigate beneath these ‘surface’ reasons for non-attendance. Thus, a realist approach was taken. The study comprised three phases of theory development and testing that incorporated qualitative telephone interviews with clients followed by a national survey of staff. All 28 clients who participated gave ‘surface’ or ‘prima-facie’ reasons for non-attendance. However, the study revealed hidden underlying factors (mechanisms). These were categorised under the themes: (i) ‘client characteristics’ e.g. ‘priority’ to score drugs and the ‘cost of travel’ (ii) ‘hepatitis C’ e.g. ‘no symptoms’ and fear of treatment ‘side-effects’ (iii) ‘clinic service’ e.g. ‘distance’ to the clinic and difficulty with ‘reimbursement’ of travel expenses. These mechanisms were produced within a complex context of factors including addiction, welfare policy and stigma. They were often played out in different ways and linked to other mechanisms. 41 out of 142 (29%) drug services in England ran a hepatitis C outreach clinic. There was general agreement with clients about reasons for nonattendance. However, there was some discordance, notably difficulty with walking. This study revealed a complex picture for non-attendance in a hepatitis C outreach clinic and makes an original contribution to knowledge about the reasons for missed appointments. This in turn has informed changes to…
author: Poll, Ray
language: en
date published: 2014
date modified: 2026-07-24T06:31:06Z
provider: Sheffield Hallam University
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Sheffield Hallam University