Late Breaking Original Research
Tuesday, October 15, 2024
08:30 AM–10:00 AM
Abstract
Introduction: Unstable housing is associated with lower odds of hepatitis C virus (HCV) treatment and cure. Additional challenges in those with housing instability include medication theft and lack of medication storage
Research Question or Hypothesis: We hypothesized that the telemedicine for HCV (TeleHCV) treatment model is most effective among those with unstable housing and that use of medication storage lockers and frequency of peer engagement is associated with higher rates of HCV initiation and cure.
Study Design: This is a sub-analysis of a randomized controlled trial comparing peer-facilitated TeleHCV to enhanced usual care for HCV treatment and cure.
Methods: Poisson regression with robust standard error estimation was utilized with HCV viral clearance as the outcome, treatment assignment as the exposure, and housing status the effect modifier of interest. Secondary exposures were frequency of peer contacts and use of a medication storage and delivery locker.
Results: 141 of 203 participants were unstably housed. Viral clearance was less likely among participants with unstable housing; 48/141 (34%), vs. 31/62 (50%) among stably housed (RR = 0.68, 0.49-0.96, p = .026). Among TeleHCV, unstably housed participants were more likely to attain HCV cure compared to stably housed participants (p for interaction between treatment assignment and housing status = .022). Unstably housed participants in TeleHCV were more likely to attain viral clearance compared to those in the usual care arm (RR = 6.47, 3.12–13.43, p < .001). There was no association between locker utilization and HCV treatment initiation or cure by housing status (p values for interactions = 0.63 and 0.7, respectively).
Conclusion: TeleHCV was approximately three times more effective at increasing the rate of HCV viral clearance among unstably housed participants than housed participants. Despite an unclear effect on outcomes, medication lockers allowed participants to receive medications in a system that would have otherwise excluded them.
Presenting Author
Megan Herink PharmDOregon State University/Oregon Health & Science University
Authors
Ryan Cook PhD
Oregon Health & Science University
Devin Gregorie MS
Oregon Health & Science University
Gillian Leichtling BA
Comagine Health
Andrew Seaman MD
Oregon Health & Science University
Hunter Spencer DO
Oregon State University