Development, implementation, and feasibility of site-specific hepatitis C virus treatment workflows for treating vulnerable, high-risk populations: protocol of the Erase Hep C study — a prospective single-arm intervention trial

Pilot and Feasibility Studies

Study Protocol

Deepak Agrawal¹  Cristal Brown²  Kia Reinis³  Darlene Bhavnani³  Patrick Chang³  Anmol Desai³  Michael Stefanowicz⁴  Tim Mercer⁵  Audrey Kuang⁵  Lauren O’Neal⁶ 

[1] Department of Internal Medicine, The University of Texas at Austin Dell Medical School, Austin, USA;Department of Internal Medicine, The University of Texas at Austin Dell Medical School, Austin, USA;CommUnityCare Health Centers, Austin, USA;Department of Population Health, The University of Texas at Austin Dell Medical School, Austin, USA;Department of Population Health, The University of Texas at Austin Dell Medical School, Austin, USA;CommUnityCare Health Centers, Austin, USA;Department of Population Health, The University of Texas at Austin Dell Medical School, Austin, USA;Department of Internal Medicine, The University of Texas at Austin Dell Medical School, Austin, USA;CommUnityCare Health Centers, Austin, USA;The University of Texas at Austin Dell Medical School, Austin, USA;

关键词: Hepatitis C virus;    Homelessness;    Intravenous drug use;    Implementation science;    Simplified treatment;    Site-specific treatment;    Direct-acting antivirals;    Sustained virological response;    Healthcare for the Homeless;    People who inject drugs;   

DOI  :  10.1186/s40814-023-01311-4

 received in 2022-12-21, accepted in 2023-04-26,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundHepatitis C virus (HCV) is the leading indication for liver transplantation and liver-related mortality. The development of direct-acting antivirals (DAA) and a simplified treatment algorithm with a > 97% cure rate should make global elimination of HCV an achievable goal. Yet, vulnerable populations with high rates of HCV still have limited access to treatment. By designing locally contextualized site-specific HCV treatment workflows, we aim to cure HCV in vulnerable, high-risk populations, including people experiencing homelessness (PEH) and people who inject drugs (PWID), in Austin, TX, USA.MethodsOur implementation science study will utilize a qualitative and design thinking approach to characterize patient and systemic barriers and facilitators to HCV treatment in vulnerable, high-risk populations seeking care across seven diverse primary care clinics serving PEHs and PWIDs. Qualitative interviews guided by the Practical, Robust Implementation and Sustainability Model (PRISM) framework will identify barriers and facilitators by leveraging knowledge and experience from both clinic staff and patients. Data synthesized using thematic analysis and design thinking will feed into workshops with clinic stakeholders for idea generation to design site-specific HCV treatment workflows. Providers will be trained on the use of a simplified HCV treatment algorithm with DAAs and clinic staff on the new site-specific HCV treatment workflows. These workflows will be implemented by the seven diverse primary care clinics serving vulnerable, high-risk populations. Implementation and clinical outcomes will be measured using data collected through interviews with staff as well as through medical chart review.DiscussionOur study provides a model of how to contextualize and implement site-specific HCV treatment workflows targeting vulnerable, high-risk populations in other geographic locations. This model can be adopted for future implementation research programs aiming to develop and implement site-specific treatment workflows for vulnerable, high-risk populations and in primary care clinical settings for other disease states beyond just HCV.Trial registrationRegistered on ClinicalTrials.gov on July, 14, 2022. Identifier: NCT05460130.

【 授权许可】

CC BY   
© The Author(s) 2023

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