Reviewing the Use of a Fibroscan® Machine in Belfast Trust Addictions Service

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.