Increasing Access to HCV Treatment Through Facilitated Telemedicine, with Andrew Talal, MD

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Talal discusses the integration of a facilitated telemedicine approach into opioid treatment centers in New York, giving people with opioid use disorder easier access to HCV treatment.

Although direct-acting antiviral therapy is highly efficacious for curing hepatitis C virus (HCV), treatment access remains an issue hindering its uptake, especially among individuals in notoriously underserved patient populations. However, a recent study is shining light on a potential solution: facilitated telemedicine.

Whereas standard telemedicine often requires patients to supply their own phone, computer, or other technology necessary to remotely connect with a healthcare provider, facilitated telemedicine includes in-person connectivity with a health care staff member who aids connection between a patient and an off-site clinician, thus offering a way to increase telemedicine entry points for underserved patient populations.

Specifically, the study explored the impact of integrating facilitated telemedicine into opioid treatment programs across New York, offering treatment to individuals with opioid use disorder on-site at their program as opposed to referring them to an off-site hepatitis specialist.

Lead study investigator Andrew Talal, MD, professor in the department of medicine at Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, explained the rationale behind this facilitated telemedicine model and the idea of integrating it into opioid treatment programs in New York. In the study, individuals with opioid use disorder who tested positive for HCV were able to receive both methadone and co-administered HCV treatment through this embedded program that provided them with tools necessary for telemedicine they may not otherwise have access to.

Among those who received facilitated telemedicine, 92.4% initiated HCV treatment compared to 40.4% in the off-site referral group, and cure percentages were significantly greater with telemedicine (90.2%) as opposed to referral (39.4%).

Talal also highlighted other notable findings, calling attention to disparities in cure rates among Hispanic female participants and participants residing in rural counties who received facilitated telemedicine versus referral: “Very few achieved a sustained response in the referral arm, whereas almost everybody in the facilitated telemedicine arm was cured of their hep C in those 2 populations.”

However, Talal was careful to express caution about the interpretation of those findings since they were not a priori. Additionally, he mentioned the limited number of study sites and all of them being located in New York as notable limitations, additionally highlighting potential differences regarding the availability of methadone in New York versus other states that may impact the effect of an integrated facilitated telemedicine approach for HCV. Nonetheless, he mentioned plans to explore future implementation of such a program in other states.

Reference:

Brooks, A. Facilitated Telemedicine Through Opioid Treatment Program Increases HCV Treatment Access. HCPLive. April 3, 2024. Accessed April 4, 2024. https://www.hcplive.com/view/facilitated-telemedicine-through-opioid-treatment-program-increases-hcv-treatment-access

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