Residential Substance User Treatment Programs as Venues for HCV Pharmacological Treatment: Client and Staff Perspectives

Abstract

Hepatitis C virus (HCV) infection is highly prevalent among drug users. While there are antiviral medications available to combat the virus, the medication regimen is quite arduous, presenting special issues for drug users. We examined the challenges and benefits of using residential substance user treatment programs as venues for clients to undergo HCV medication regimens. Analyses of qualitative data collected from clients and staff in 2003 at four residential substance user treatment programs in the U.S. indicate that challenges primarily include issues involving the medications' side effects, and both financial and communication concerns. Benefits especially involve clients' feelings that they are being proactive in addressing health issues in an environment that provides much-needed support. Findings illuminate the complex issues involved for both clients and the programs, and some steps that programs can take to better support HCV-infected clients regarding HCV medication concerns.

Facilitators of HCV treatment adherence among people who inject drugs: a systematic qualitative review and implications for scale up of direct acting antivirals

“…i.e., did the data provide sufficient depth, detail, and richness? Total Harris (2009) [ 47 ] 1 1 1 1 1 0 1 6 Harris (2013) [ 35 ] 1 1 1 1 1 1 1 7 Hopwood (2007) [ 29 ] 1 1 1 1 1 1 1 7 Munoz Plaza (2008) [ 30 ] 1 1 1 1 1 1 1 7 Nguyen (2007) [ 31 ] 1 1 0 1 1 0 1 5 Norman (2008) [ 32 ] 1 1 1 1 1 1 1 7 Strauss (2005) [ 12 ] 1 1 1 1 1 1 1 7 Treloar (2008) [ 27 ] 1 1 1 1 1 1 1 7 Treloar (2013) [ 33 ] 1 1 1 1 1 1 1 7 Rasi (2014) [ 34 ] …”

“…For decades, interferon-based therapy has been the standard of care for HCV, most popularly a regimen of pegylated interferon and ribavirin (pegIFN + RBV). However, long treatment courses, hematologic and psychiatric side effects, and the uncertainty of achieving SVR complicate interferon-based treatment for many patients and providers [ 11 , 12 ]. Even for patients who pass screening for treatment, implementation can be challenging.…”

Enhancing Drug Treatment Program Staff's Self-Efficacy to Support Patients' HCV Needs

“…Participants also completed a variety of assessments and scales, including a 10-item “HCV Self-efficacy Scale” (Strauss et al, 2007b). The research team developed this Scale using insights gained from our previous research, as well as those gained after speaking with managers in drug treatment programs and clinicians who provide care for drug users with HCV infection (Munoz-Plaza, Strauss, Astone, Des Jarlais, & Hagan, 2004; Strauss et al, 2005). Items on the Scale involved staff’s confidence in discussing HCV-related issues with HCV+ and HCV− patients, helping patients deal with HCV-related ambivalence and denial, and responding to patients’ HCV questions and concerns.…”

“…Substance abuse treatment program staff often provide effective support to their patients recovering from drug addiction, suggesting that these staff can be instrumental in assisting them with their infectious disease-related needs. However, staff in substance abuse treatment programs vary in the extent to which they provide HCV-related assistance (Astone-Twerell, Strauss, Munoz-Plaza, Hagan, & Des Jarlais, 2005; Strauss, Astone, Munoz-Plaza, Hagan, & Des Jarlais, 2005), highlighting the importance of examining ways to increase their level of HCV-related support.…”

Correlates of Drug Treatment Program Staff's Self Efficacy to Support Their Clients' Hepatitis C Virus (HCV) Related Needs

“…Staff vary, however, in the extent to which they offer HCV related assistance (5,6), suggesting the importance of examining ways in which their level of support can be increased. Shown to be a salient predictor of performance in a variety of occupational fields (7), self efficacy, a psychological attribute that can be learned and improved (8,9), may be important in encouraging drug treatment program staff's provision of HCV related assistance.…”