Theme: Clinical Research Year: 2019
Background: Social determinants of health (SDOH), i.e., social, behavioral and environmental
factors, are increasingly recognized for their important influence on health outcomes. Data are
limited on the influence of SDOH, substance use characteristics, and their interactions on pursuit of
hepatitis C virus (HCV) care among individuals with opioid use disorder (OUD). Linkage to HCV care
remains low in this population despite high HCV prevalence and incidence. Our objective was to
investigate the influence of SDOH, substance use factors, and their interactions on HCV treatment
uptake among OUD patients in a methadone treatment program.
Methods: Information on patient demographics, SDOH, substance use characteristics, and comorbid medical conditions were obtained from the paper and electronic medical records of OUD
patients on methadone. We applied multiple correspondence analysis, k-means algorithm, and
logistic regression with least absolute shrinkage and selection operator penalty to identify variables
and clusters associated with pursuit of HCV care.
Results: Data from 161 patients (57% male, 60% Caucasian, mean age 45 years) were evaluated.
Being employed, the absence of support systems, and a history of foster care were the strongest
positive predictors of treatment pursuit. The use of crack/cocaine as the initial illicit substance,
criminal activity without incarceration, and the absence of a family history of chemical dependency
were the strongest negative predictors. We identified clusters among persons with OUD based upon
their likelihood to pursue HCV management.
Conclusion: Utilizing data from the medical record, we were able to identify factors positively and
negatively associated with linkage-to-care for HCV. We were also able to divide patients into clusters
of factors associated with linkage-to-care for HCV. These results could be used to identify individuals
with OUD based upon their readiness for HCV care.
Disclosure of Interest Statement: None