‘Not just Methadone Tracy’: transformations in service-user identity following the introduction of hepatitis C treatment into Australian opiate substitution settings

Rance, Jake; Treloar, Carla

doi:10.1111/add.12392

Cited by 31 publications

(36 citation statements)

References 20 publications

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“…In particular, peer educators have been identified as influential in cultivating effective HCV care (Galindo et al, 2007; Norman et al, 2008; Rance et al, 2014; Rance and Treloar, 2014) as they promote patient empowerment and are able to share their lived experiences of HCV treatment (Norman et al, 2008). Further, peer educator involvement may be especially central to patient engagement when patients have had negative healthcare experiences in the past (Treloar et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have identified associations between changes in self-perception and promotion of self-care, including reduced injection practices (Jauffret-Roustide et al, 2012). In a recent qualitative study, Rance and colleagues (2014) described identity reconceptualization among individuals who initiated HCV treatment within an opiate substitution therapy setting in Australia. The authors suggested that HCV treatment enabled patients to move from conceptualizing themselves as “addicts” or substance users to conceptualizing themselves as patients with a curable illness worthy of medical treatment.…”

Section: Discussionmentioning

confidence: 99%

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“Hepatitis C treatment turned me around:” Psychological and behavioral transformation related to hepatitis C treatment

Batchelder

Peyser

Nahvi

et al. 2015

Drug and Alcohol Dependence

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Background Hepatitis C (HCV) is a significant public health problem that primarily affects current and former substance users. However, individuals with a history of substance use are less likely to have access to or engage in HCV care. Psychological and behavioral barriers prevent many HCV-infected individuals from initiating or engaging in HCV treatment. This study aimed to investigate the psychological and behavioral experiences of current and former substance users receiving HCV treatment within a combined methadone and primary care clinic in the United States. Methods We conducted 31 semi-structured qualitative interviews with opioid-dependent adults enrolled in an integrated HCV treatment program within a methadone maintenance clinic in the Bronx, NY. We used thematic analysis, informed by grounded theory, and inquired about perceptions of HCV before and after initiating HCV treatment, reasons for initiating HCV treatment, and the decision to participate in individual versus group HCV treatment. Results Participants described psychological and behavioral transformation over the course of HCV treatment. These included reductions in internalized stigma and shame related to HCV and addiction, increases in HCV disclosure and self-care, reductions in substance use, and new desire to help others who are living with HCV. Conclusions Integrating HCV treatment with methadone maintenance has the potential to create psychological and behavioral transformations among substance using adults, including reductions in HCV- and addiction-related shame and improvements in overall self-care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“Hepatitis C treatment turned me around:” Psychological and behavioral transformation related to hepatitis C treatment

Batchelder

Peyser

Nahvi

et al. 2015

Drug and Alcohol Dependence

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“…A key issues in the stigma literature is to ensure that we engage, including within our research, with the structural elements that shape perceptions of HCV and people who inject drugs and avoid individualising these factors to an issue of knowledge, attitude or practice (Harris & Rhodes, 2013; Paterson, Backmund, Hirsch, & Yim, 2007). With DAAs, additional new questions arise around people's expectations of treatment (Harris, 2017), supporting people to avoid reinfection as well as the impact of HCV cure on individual's sense of self and identity (Rance & Treloar, 2014). …”

Section: Approach To These Research Prioritiesmentioning

confidence: 99%

Research priorities to achieve universal access to hepatitis C prevention, management and direct-acting antiviral treatment among people who inject drugs

Grebely

Bruneau

Lazarus

et al. 2017

International Journal of Drug Policy

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Globally, it is estimated that 71.1 million people have chronic hepatitis C virus (HCV) infection, including an estimated 7. 5 million people who have recently injected drugs (PWID). There is an additional large, but unquantified, burden among those PWID who have ceased injecting. The incidence of HCV infection among current PWID also remains high in many settings. Morbidity and mortality due to liver disease among PWID with HCV infection continues to increase, despite the advent of well-tolerated, simple interferon-free direct-acting antiviral (DAA) HCV regimens with cure rates >95%. As a result of this important clinical breakthrough, there is potential to reverse the rising burden of advanced liver disease with increased treatment and strive for HCV elimination among PWID. Unfortunately, there are many gaps in knowledge that represent barriers to effective prevention and management of HCV among PWID. The Kirby Institute, UNSW Sydney and the International Network on Hepatitis in Substance Users (INHSU) established an expert round table panel to assess current research gaps and establish future research priorities for the prevention and management of HCV among PWID. This round table consisted of a one-day workshop held on 6 September, 2016, in Oslo, Norway, prior to the International Symposium on Hepatitis in Substance Users (INHSU 2016). International experts in drug and alcohol, infectious diseases, and hepatology were brought together to discuss the available scientific evidence, gaps in research, and develop research priorities. Topics for discussion included the epidemiology of injecting drug use, HCV, and HIV among PWID, HCV prevention, HCV testing, linkage to HCV care and treatment, DAA treatment for HCV infection, and reinfection following successful treatment. This paper highlights the outcomes of the roundtable discussion focused on future research priorities for enhancing HCV prevention, testing, linkage to care and DAA treatment for PWID as we strive for global elimination of HCV infection.

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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%

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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‘Not just Methadone Tracy’: transformations in service-user identity following the introduction of hepatitis C treatment into Australian opiate substitution settings

Cited by 31 publications

References 20 publications

“Hepatitis C treatment turned me around:” Psychological and behavioral transformation related to hepatitis C treatment

“Hepatitis C treatment turned me around:” Psychological and behavioral transformation related to hepatitis C treatment

Research priorities to achieve universal access to hepatitis C prevention, management and direct-acting antiviral treatment among people who inject drugs

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

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