Original Research
Tuesday, November 14, 2023
08:30 AM–10:00 AM
Abstract
Introduction:
Hepatitis C (HCV) treatment in people who use drugs (PWUD) is essential for achieving HCV elimination, yet, fewer than 10% are treated. Medication receipt and storage is a barrier for PWUD to complete HCV treatment, especially for houseless individuals.
Research Question or Hypothesis:
Does establishing a medication locker protocol and sending HCV medications to a local syringe service program (SSP) for peer-facilitated support improve treatment initiation, completion, and cure rates?
Study Design:
post-hoc subgroup analysis of randomized controlled trial
Methods:
Between 2020 and 2022, PWUD with HCV in 5 rural Oregon counties were randomized to peer-facilitated telemedicine treatment (TeleHepC) versus referral to local providers. Participants randomized to TeleHepC, who completed a provider visit, and prescribed medication were included. A Medication Storage Protocol was created, and participants had medications sent to a private mailing address (non-SSP) or to a local SSP to be stored for peer-assisted initiation. The primary outcome was sustained virologic response 12 weeks post-treatment (SVR12). Statistical analysis included descriptive statistics and student t-test for comparisons.
Results:
Of 100 participants randomized to TeleHepC, 88 were included in this post-hoc analysis. The sample was predominantly male (58%) and white (89%) with median age 41 (IQR 32-48). 63% of participants utilized medication lockers and participants with recent houselessness were more likely to do so (78% vs 41%; p<0.001). Comparing SSP to non-SSP, treatment initiation rates were the same (93%), treatment completion was lower (57% vs. 83%; p<0.05) and SVR12 was similar (71% vs. 72%; p>0.05).
Conclusion:
The majority of houseless PWUD in rural communities elected to have HCV medications delivered to a local SSP and used a peer-assisted medication locker to facilitate treatment initiation and adherence. Despite a higher prevalence of houselessness, those who used medication lockers had similar treatment initiation and SVR rates as those who used traditional care models.
Presenting Author
Megan Herink PharmDOregon State University/Oregon Health & Science University
Authors
Todd Korthuis MD
Oregon Health & Science University
Gillian Leichtling BA
Comagine Health
Tonhi Gailey BS
Oregon Health & Science University
HaYoung Ryu PharmD
Oregon Health & Science University
Andrew Seaman MD
Oregon Health & Science University
Hunter Spencer MD
Oregon State University