Promoting Hepatitis C Virus Screening And Linkage To Care For Opioid Users Through A Mobile-Health System: Early Experience From A Randomized Trial

Author: Hochstatter KR, Landucci G, Gustafson DH, Maus A, Westergaard RP

Theme: Epidemiology & Public Health Research Year: 2017

Background: Opioid use disorders are increasingly driving new hepatitis C virus (HCV) infections. Mobile health applications delivered by smartphones represent a promising innovative strategy to promote HCV prevention and improve engagement in care for substance using populations.

Methods: We analyzed preliminary data from a randomized trial of a mobile health intervention designed to improve retention in medication-assisted treatment for people with opioid use disorder. Services designed to help prevent HCV infection and improve care were incorporated into an existing evidence-based smartphone application, called A-CHESS, to capture data on risk behaviors and HCV screening and care. We used weekly survey data to measure movement across the HCV care continuum of screening, linkage to care, and treatment initiation.

Results: To date, 170 individuals have been enrolled and completed the baseline survey (87 control, 83 intervention). 976 weekly surveys were taken by 72 participants enrolled in the intervention group.

At baseline, 26 of the 72 individuals (36%) were HCV at-risk/untested, 21 (29%) were HCV-negative, 22 (31%) had active HCV and had never received treatment, and 3 (4%) had active HCV infection and had received treatment.

Based on weekly data collected by A-CHESS, 20 of the 72 participants (28%) were noted to change to a different stage in the HCV care continuum after a median of 13.6 weeks of follow-up. These included:

14 individuals had advanced to a later stage in the HCV care continuum (e.g. from HCV positive/untreated to HCV positive/treated).

6 individuals had reported engaging in risky drug use behaviors and reverted to the stage of at-risk/untested (e.g. from HCV-negative to HCV at-risk/untested).

Conclusion: Delivering HCV prevention and care information and collecting survey data through smart-phone applications provide a novel approach to increase screening, link people to care, and measure movement across the HCV care continuum among people with opioid use disorders.

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