Inpatient Hepatitis C Treatment Coordination and Initiation for Patients Who Inject Drugs.
| Title: | Inpatient Hepatitis C Treatment Coordination and Initiation for Patients Who Inject Drugs. |
|---|---|
| Authors: | McCrary LM; Department of Medicine, University of North Carolina, Chapel Hill, NC, USA. mccrary@wustl.edu.; Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA. mccrary@wustl.edu.; Roberts KE; Graduate School of Social Work and Social Research, Bryn Mawr College, Bryn Mawr, PA, USA.; Bowman MC; Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.; Castillo B; Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.; Darling JM; Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.; Dunn C; Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA.; Jordan R; Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA.; Young JE; Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA.; Schranz AJ; Department of Medicine, University of North Carolina, Chapel Hill, NC, USA. |
| Source: | Journal of general internal medicine [J Gen Intern Med] 2023 Nov; Vol. 38 (15), pp. 3428-3433. Date of Electronic Publication: 2023 Aug 31. |
| Publication Type: | Journal Article; Research Support, N.I.H., Extramural |
| Language: | English |
| Journal Info: | Publisher: Springer Country of Publication: United States NLM ID: 8605834 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1525-1497 (Electronic) Linking ISSN: 08848734 NLM ISO Abbreviation: J Gen Intern Med Subsets: MEDLINE |
| Imprint Name(s): | Publication: Secaucus, NJ : Springer; Original Publication: [Philadelphia, PA] : Hanley & Belfus, [c1986- |
| MeSH Terms: | Hepatitis C, Chronic*/drug therapy ; Hepatitis C, Chronic*/epidemiology ; Substance Abuse, Intravenous*/complications ; Substance Abuse, Intravenous*/epidemiology ; Substance Abuse, Intravenous*/drug therapy ; Hepatitis C*/drug therapy ; Hepatitis C*/epidemiology; Antiviral Agents/therapeutic use ; Humans ; Inpatients ; Hepacivirus |
| Abstract: | Background: With hepatitis C (HCV) incidence rising due to injection drug use, people who inject drugs (PWID) are a priority population for direct-acting antivirals (DAA). However, significant barriers exist. At our institution, hospitalized PWID were screened for HCV but not effectively linked to care.; Aim: To improve retention in HCV care among hospitalized PWID.; Setting: Quaternary academic center in the Southeast US from August 2021 through August 2022.; Participants: Hospitalized PWID with HCV.; Program Description: E-consultation-prompted care coordination and HCV treatment with outpatient telehealth.; Program Evaluation: Care cascades were constructed to assess retention and HCV treatment, with the primary outcome defined as DAA completion or sustained virologic response after week 4. Of 28 patients, 11 started DAAs inpatient, 8 initiated outpatient, and 9 were lost to follow-up or transferred care. Overall, 82% were linked to care and 52% completed treatment. For inpatient initiators, 73% achieved the outcome. Of non-inpatient initiators, 71% were linked to care, 53% started treatment, and 36% achieved the outcome.; Discussion: Inpatient HCV treatment coordination, including DAA initiation, and telehealth follow-up, was feasible and highly effective for hospitalized PWID. Future steps should address barriers to inpatient DAA treatment and expand this model to other similar patient populations.; (© 2023. The Author(s), under exclusive licence to Society of General Internal Medicine.) |
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| Grant Information: | K23 DA049946 United States DA NIDA NIH HHS; K23DA049946 United States DA NIDA NIH HHS |
| Contributed Indexing: | Keywords: hepatitis C; hospitalization; injection drug use; substance use |
| Substance Nomenclature: | 0 (Antiviral Agents) |
| Entry Date(s): | Date Created: 20230831 Date Completed: 20231128 Latest Revision: 20250909 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC10682347 |
| DOI: | 10.1007/s11606-023-08386-y |
| PMID: | 37653211 |
| Database: | MEDLINE |
Journal Article; Research Support, N.I.H., Extramural