These individuals were 3 times more likely to be cured of the infectious disease than those referred out to local clinics through patient navigation services, clinical trial results indicate.
Individuals with hepatitis C who injected drugs and were treated at a non-stigmatizing accessible-care treatment with a syringe service program (SSP) were about 3 times more likely to be cured of the infectious disease than those referred out to local clinics through patient navigation services, results of a clinical trial showed.
The results of the study, conducted by CUNY Graduate School of Public Health and Health Policy, NYU Grossman School of Medicine, New York-Presbyterian, and Weill Cornell Medicine, suggests that expanding and supporting the accessible-care model could be instrumental in eliminating the disease.
The trial was conducted between July 2017 and March 2021 and included 167 individuals who were randomly assigned to either accessible care or referred out to local physicians by patient navigators who facilitated the process.
Individuals in the study were followed for 1 year after study enrollment.
“We were able to engage and offer treatment to people who are currently injecting drugs, people who are often excluded from traditional health care settings because of their drug use,” Shashi Kapadia, MD, assistant professor of medicine in the Division of Infectious Diseases at Weill Cornell Medicine, said in a statement.
The hepatitis C cure rate was approximately 86% for both arms of the study for those who completed treatment, but approximately 67% of those enrolled in accessible care at the SSP finished the course compared with approximately 23% of those assigned to the standard care.
In more traditional settings, individuals are required to document to that they are no longer using drugs to qualify for hepatitis C treatment, but investigators said that individuals who still use drugs can be cured, because requiring abstinence adds another barrier to care access.
Individuals who use drugs, specifically injectable drugs, are often stigmatized in health care settings and might be treated poorly, which makes them reluctant to get help, investigators said.
Additionally, drug use could be a distraction for individuals for treatment as well as contribute to missing appointments, which in a traditional setting can lead to them being dropped from care.
By contrast, the accessible-care team that was part of the study offered walk-in appointments. Additionally, individuals who had appointments and missed them were contacted to reschedule.
The staff members were also available and trained to interact with individuals who used drugs.
Flexibility made the accessible-care models attractive, investigators said, adding that participants were not just locals but individuals who lived in other New York City’s borough and not just Manhattan.
“This study provides a practical guide for how to make an effective treatment accessible to the population most likely to have the disease,” Kristen Marks, MD, associate professor of medicine at Weill Cornell Medicine and an infectious disease specialist at New York-Presbyterian/Weill Cornell Medical Center, said in the statement.
The investigators acknowledged that most individuals in the study had insurance that covered their treatment, which could be a limitation of the study.
Accessible care key to treating hepatitis C in people who inject drugs. EurekAlert. News release. April 7, 2022. Accessed April 14, 2022. https://www.eurekalert.org/news-releases/949093