Slicing through silos: Development and evaluation of a hospital-based telehealth hepatitis C virus treatment program

• Published in: The International journal of drug policy 2024-05, Vol.127, p.104396-104396, Article 104396
• Main Authors: Babiarz, J., Ryu, H., Williams, C., Ham, Y., Rivera Sarti, J., Levander, X.A.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antiviral Agents - administration & dosage; Antiviral Agents - therapeutic use; Benzimidazoles - administration & dosage; Benzimidazoles - therapeutic use; Carbamates - administration & dosage; Cohort Studies; Drug Combinations; Female; Hepatitis C - drug therapy; Hepatitis C, Chronic - drug therapy; Heterocyclic Compounds, 4 or More Rings - administration & dosage; Heterocyclic Compounds, 4 or More Rings - therapeutic use; Hospitalization - statistics & numerical data; Humans; Lactams, Macrocyclic; Male; Middle Aged; Prospective Studies; Pyrrolidines - administration & dosage; Quinoxalines - administration & dosage; Quinoxalines - therapeutic use; Sofosbuvir - administration & dosage; Sulfonamides - administration & dosage; Sustained Virologic Response; Telemedicine
• ISSN: 0955-3959; 1873-4758
• DOI: 10.1016/j.drugpo.2024.104396

•A telehealth program can successfully treat hepatitis C virus infection in hospitalized patients who were previously unable to get treated.•A multidisciplinary team that includes social work and pharmacy services is critical for treatment adherence and addressing social determinants of health.•Engagement of vulnerable patients in a telehealth hepatitis C program can help promote patient self-efficacy and trust in healthcare systems. There exist many barriers to hepatitis C virus (HCV) treatment for those with substance use disorder (SUD) or who lack access to routine medical care. A hospital-based telehealth program was developed to provide treatment opportunities for hospitalized patients living with HCV. This single site prospective cohort study conducted from July 2022 to March 2023 aimed to measure linkage to care with an HCV clinician and initiation of HCV treatment in hospitalized patients. Patients were assessed in-person by a social worker then seen via telehealth by a clinician who prescribed either glecaprevir/pibrentasvir or sofosbuvir/velpatasvir. Treatment was initiated with pharmacist assistance. The team conducted in-person and/or telephonic outreach during and after hospitalization. Cure was confirmed by sustained virologic response at 12 weeks (SVR12) post-treatment. A total of 25 patients were enrolled and completed telehealth visits. All patients had a history of SUD and 18 (72 %) were unstably housed. Nineteen patients (76 %) initiated treatment, and 14 (56 %) successfully completed treatment. Twelve patients (48 %) completed post-treatment labs, including two who prematurely discontinued treatment. Eleven patients (44 %) achieved confirmed cure with SVR12. : A hospital-based, multidisciplinary telehealth program can be an innovative care model to successfully treat HCV in a difficult-to-treat patient populations.