Barriers and Facilitators for HCV Treatment Engagement within Integrated Care Delivery Models
Uptake of hepatitis C (HCV) treatment among patients with opioid use disorders tends to be low. This qualitative investigation explored the barriers and facilitators affecting the delivery and uptake of HCV care and treatment within opioid treatment programs. Patients, healthcare professionals, and peer workers from the centers were recruited for in-depth, semi-structured interviews. Patient participants were separated into three groups: those without engagement in HCV care; those who were assessed for HCV care but did not follow through with further care or treatment; and those who were actively engaged in HCV care and treatment.
- Overall, 76 interviews were completed; 56 were with patients and 19 were with staff.
- Differences emerged between the patient groups. Among those who never engaged in HCV care, barriers included the participants’ perception that they were physically well and asymptomatic, other life priorities, and concern about side effects of treatment. Patients who engaged in care were motivated by close contacts becoming sick, wanting to live longer, and hearing positive stories of treatment.
- Presence of an engaged clinician and treatment accessibility facilitated patients’ engagement in this integrated care model.
Comments:This investigation supports previous reports that integrated care delivery models of HCV treatment within opioid agonist treatment settings improve engagement in HCV care. Increasing education and outreach and the development of more tolerable treatment regimens show promise for improving HCV treatment engagement among patients with opioid use disorder. Jeanette M. Tetrault, MD
Treloar C, Rance J, Dore GJ, Grebely J. Barriers and facilitators for assessment and treatment of hepatitis C virus infection in the opioid substitution treatment setting: insights from the ETHOS study. J Viral Hepat. 2013 [Epub ahead of print]. doi: 10.1111/jvh.12183.