Client and staff experiences of a co-located service for hepatitis C care in opioid substitution treatment settings in New South Wales, Australia

Treloar, Carla; Rance, Jake; Grebely, Jason; Dore, Gregory J.

doi:10.1016/j.drugalcdep.2013.07.023

Cited by 27 publications

(44 citation statements)

References 27 publications

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“…In a meta-analysis of interferon-based studies among PWID, engagement in addiction treatment was associated with higher treatment completion [12]. Previous studies have demonstrated that the colocation of HCV services and drug treatment can be successfully integrated [34], with the colocation of HCV care in OST clinics welcomed by the large majority of participants and providers [35]. Further efforts are needed to expand the integration of HCV DAA therapy in drug and alcohol clinics and community health clinics that also provide OST.…”

Section: Discussionmentioning

confidence: 99%

Sofosbuvir-Based Direct-Acting Antiviral Therapies for HCV in People Receiving Opioid Substitution Therapy: An Analysis of Phase 3 Studies

Grebely

Feld

Wyles

et al. 2018

Open Forum Infectious Diseases

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BackgroundHepatitis C virus (HCV) direct-acting antiviral therapy is effective among people receiving opioid substitution therapy (OST), but studies are limited by small numbers of nongenotype 1 (GT1) patients. The aim of this study was to evaluate the treatment completion, adherence, SVR12, and safety of sofosbuvir-based therapies in HCV patients receiving and not receiving OST.MethodsTen phase 3 studies of sofosbuvir-based regimens included ION (ledipasvir/sofosbuvir ± ribavirin for 8, 12, or 24 weeks in GT1), ASTRAL (sofosbuvir/velpatasvir for 12 weeks in GT1-6), and POLARIS (sofosbuvir/velpatasvir and sofosbuvir/velpatasvir/voxilaprevir in GT1-6). Patients with clinically significant drug use (last 12 months) or noncannabinoids detected at screening were ineligible.ResultsAmong 4743 patients, 4% (n = 194) were receiving OST (methadone; n = 113; buprenorphine, n = 75; other, n = 6). Compared with those not receiving OST (n = 4549), those receiving OST (n = 194) were younger (mean age, 48 vs 54), more often male (73% vs 61%), GT3 (38% vs 17%), treatment-naïve (78% vs 65%), and cirrhotic (36% vs 23%). Among those receiving and not receiving OST, there was no significant difference in treatment completion (97% vs 99%, P = .06), SVR12 (94% vs 97%, P = .06), relapse (0.5% vs 2.1%, P = .19), adverse events (78% vs 77%, P = .79), or serious adverse events (3.6% vs 2.4%, P = .24). There was no difference in SVR12 in patients with cirrhosis (99% vs 95%, P = .25) or those with G3 (95% vs 95%, P = .77) in those receiving OST. Among patients receiving OST, SVR12 was high among those receiving methadone (95%) and buprenorphine (96%).ConclusionSofosbuvir-based therapies are effective and safe in patients receiving OST.

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Section: Discussionmentioning

confidence: 99%

Sofosbuvir-Based Direct-Acting Antiviral Therapies for HCV in People Receiving Opioid Substitution Therapy: An Analysis of Phase 3 Studies

Grebely

Feld

Wyles

et al. 2018

Open Forum Infectious Diseases

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“…Among the six qualitative studies, none reported the researchers’ cultural or theoretical positions . In one study, the research methodology (qualitative approach for evaluation) and data collection method (telephone structured interview) were incongrous .…”

Section: Resultsmentioning

confidence: 99%

“…In one study, the research methodology (qualitative approach for evaluation) and data collection method (telephone structured interview) were incongrous . Three studies also did not address the influence of the researcher on the research and vice‐versa, and this issue was also unclear in one another study . The other criteria were met by all studies.…”

Section: Resultsmentioning

confidence: 99%

Clinical effectiveness, cost effectiveness and acceptability of community‐based treatment of hepatitis C virus infection: A mixed method systematic review

Pourmarzi

Hall

Hepworth

et al. 2019

Journal of Viral Hepatitis

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Summary Several community‐based models for treating hepatitis C virus (HCV) infection have been implemented to improve treatment accessibility and health outcomes. However, there is a lack of knowledge regarding how well these models achieve the desired goals. We conducted a mixed‐method systematic review of quantitative and qualitative evidence about clinical effectiveness, cost effectiveness and acceptability of community‐based HCV treatment models. Seventeen databases were researched for published and unpublished studies. Methodological quality was assessed using The Joanna Briggs Institute Critical Appraisal tools. Quantitative findings were synthesized in narrative form and qualitative findings were synthesized using meta‐synthesis. Forty‐two quantitative and six qualitative studies were included. No relevant cost effectiveness studies were found. Five categories of community‐based models were identified: telehealth, integration of HCV and addiction services, integration of HCV and HIV services, integration of HCV and primary care, and implementation by a home care and health care management company. The range of reported outcomes included; end of treatment response: 48.7% to 96%, serious side effects: 3.3% to 27.8%, sustained virological response: 22.3% to 95.5%, relapse: 2.2% to 16.7%, and treatment completion: 33.4% to 100%. Inconsistent measures of uptake and adherence were used; uptake ranged from 8.3% to 92%, and 68.4% to 100% of patients received ≥80% of prescribed doses. Patient reported experiences included trusted and supportive care providers, safe and trusted services, easily accessible care, and positive psychological and behavioural changes. The clinical effectiveness and acceptability reported from the included studies are similar to or better than reported outcomes from systematic reviews of studies in tertiary settings. Studies of the cost effectiveness of community‐based models for treating HCV are needed.

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“…There is ongoing evidence and recommendations for the colocation of HCV treatment and care for PWID within settings dedicated to serving PWID such as harm reduction programs including opiate substitution therapy and needle exchange as well as supports for problematic substance use (Grebely, Knight, & Genoway, 2010;Harris, Arnsten, & Litwin, 2010;Martinez et al, 2012;Treloar, Rance, Grebely, & Dore, 2013;Zeremski et al, 2013). These recommendations further emphasize the need for HCV services in settings deliberately designed for a PWID patient population (Alavi, Grebely, et al, 2013).…”

Section: Pwid Treatment With Pwid Servicesmentioning

confidence: 96%

From principles to practice: Description of a novel equity-based HCV primary care treatment model for PWID

Milne¹,

Price²,

Wallace

et al. 2015

International Journal of Drug Policy

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Client and staff experiences of a co-located service for hepatitis C care in opioid substitution treatment settings in New South Wales, Australia

Cited by 27 publications

References 27 publications

Sofosbuvir-Based Direct-Acting Antiviral Therapies for HCV in People Receiving Opioid Substitution Therapy: An Analysis of Phase 3 Studies

Sofosbuvir-Based Direct-Acting Antiviral Therapies for HCV in People Receiving Opioid Substitution Therapy: An Analysis of Phase 3 Studies

Clinical effectiveness, cost effectiveness and acceptability of community‐based treatment of hepatitis C virus infection: A mixed method systematic review

From principles to practice: Description of a novel equity-based HCV primary care treatment model for PWID

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