Date of Publication
Deborah Wachtel DNP, MPH, APRN; Robin Sherman APRN
Background: Despite harm reduction efforts, Hepatitis C virus (HCV) infections among individuals with opioid use disorder tripled between 2010 and 2015 in the US. Shifting disease burden from chronic to acute HCV, could result in $12 billion cumulative Medicaid savings in two years. Patients receiving medication for OUD (mOUD) remain at risk for HCV, but only receive screening upon admission. This project aims to implement a HCV re-screening protocol in a mOUD program, determine protocol sustainability, and secondarily evaluate need for point of care testing.
Methods: Patients with a negative screening result upon admission were prompted to opt in/out of re-screening. Participants were offered onsite venipuncture. Patients declining, were asked if they’d reconsider if blood sample were obtained via finger stick. Stakeholders provided feedback regarding sustainability via online surveys.
Results: Of the 496 eligible patients, 429[PMV1] (86%) completed the survey with 124 (29%) interested in rescreening, and 52 (41%) completed a venipuncture. Of these, 9 (17%) tested positive for HCV antibody and 7 (14%) had detectable HCV RNA. Of patients declining re-screening, n=185[PMV2] (52%), endorsed amenability to finger stick. Stakeholders (n=24) agreed that rescreening was easy to implement and appropriate to integrate into practice.
Conclusions: Provision of less invasive screening modalities may increase rescreening uptake. Introducing opportunities for HCV re-screening leads to earlier detection and subsequent treatment initiation, and increases identification rates overall. Integration of HCV screening services at mOUD treatment programs provides a sustainable approach to HCV surveillance, and has the potential reduce the burden of infectious disease.
Bray, Jacqueline, "Improving Surveillance of Hepatitis C Infections Among Patients Receiving Medication Treatment for Opioid Use Disorder" (2020). College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications. 40.