The SACC Program (Shared Addiction Care Collaboration) developed and implemented a decentralised hepatitis C shared care model in Copenhagen with the aim of decreasing hepatitis C (HCV) related transmission, morbidity and mortality among injection drug users (IDUs).
 
After the initial study ended in June 2017 the city of Copenhagen decided to continue the SACC program in all 11 counselling centres offering drug treatment in Copenhagen.

The program is funded by the City of Copenhagen. The SACC is a collaboration between the City of Copenhagen, the Department of Infectious Diseases at Rigshospitalet/Hvidovre Hospital and CHIP.

Rationale behind SACC:
Most IDUs in Denmark have never been tested for HCV infection. Among those with chronic HCV infection, only a third is being followed at a hospital clinic and few of these have received HCV treatment. The physical and organisational divide between counselling centres and the hospital have instigated low retention rates in HCV treatment and care of IDUs. Often, clients referred to treatment at the hospital never turn up or have a sporadic contact with the hospital clinic.
In recent years, substantial innovation has taken place within HCV diagnosis, evaluation of the severity of liver disease, and treatment of HCV. This strengthens the opportunity to break down barriers and facilitate integration of diagnosis and treatment of HCV locally at counselling centres.

The SACC program entails:
• Shared database (Hospital and counselling centres offering drug treatment). A "real time" database will be developed where data from relevant existing databases are gathered in a common patient chart. The health professionals at counselling centres and the Department of Infectious Diseases have access to the data. This database is banked on CHIPs experience with database-development and implementation from previous research projects.
• HCV screening and clinical evaluation: HCV testing, non-invasive evaluation of liver fibrosis (fibroscanning) and further clinical evaluation of clients in order to identify persons eligible for HCV treatment, takes place locally at the counselling centres. Prior to this phase, a strengthening of teaching and information about hepatitis C, aimed at both clients and staff, takes place.
• Implementation of a shared care treatment model. Prescription of medicine and monitoring of treatment outcome is the responsibility of the Department of Infectious Diseases, while it is responsibility of the counselling centres to ensure compliance and that different tests are carried out as prescribed.
• Research. Collection of data on HCV infection, treatment and outcome from a large population of IDUs will enable the production of scientific publications and presentations on the health status of IDUs in general and HCV-related disease and integrated hepatitis C treatment and care in particular.  This is done as means to strengthen research in health interventions aiming to secure inclusion of vulnerable and marginalized groups - and reduce inequality in access to health.

History of SACC:
The SACC project run from June 2014 to May 2017. A Project Advisory Board was established with representatives from: Social Services Administration, City of Copenhagen; counselling centres; CHIP and; Department of Infectious Diseases and Rheumatology, Rigshospitalet.
The study terminated 31st May 2017. Please see the final report here.

For further information please contact study coordinator Tina Bruun tina.bruun.01@regionh.dk