Integration of hepatitis C treatment at harm reduction centers in Georgia-Findings from a patient satisfaction survey

Maia Butsashvili; George Kamkamidze; Maia Kajaia; Lia Gvinjilia; Tatia Kuchuloria; Irma Khonelidze; Maka Gogia; Ekaterine Dolmazashvili; Vakhtang Kerashvili; Mamuka Zakalashvili; Shaun Shadaker; Muazzam Nasrullah; Shilton Sonjelle; Maia Japaridze; Francisco Averhoff

doi:10.1016/j.drugpo.2020.102893

Integration of hepatitis C treatment at harm reduction centers in Georgia-Findings from a patient satisfaction survey

Int J Drug Policy. 2020 Oct:84:102893. doi: 10.1016/j.drugpo.2020.102893. Epub 2020 Jul 31.

Authors

Affiliations

¹ Health Research Union/Clinic NEOLAB, 8 Nutsubidze str. Tbilisi 0177, Georgia. Electronic address: maiabutsashvili@gmail.com.
² Health Research Union/Clinic NEOLAB, 8 Nutsubidze str. Tbilisi 0177, Georgia.
³ TEPHINET, 9 Asatiani street, Tbilisi 0177, Georgia.
⁴ National Center for Disease Control and Public Health, 99 Kakheti Highway, Tbilisi 0198, Georgia. Electronic address: I.khonelidze@ncdc.ge.
⁵ Georgia Harm Reduction Network, 24 Shartava str. 3rd floor, apt 6., Tbilisi, Georgia. Electronic address: mgogia@hrn.ge.
⁶ Clinic HEPA, 18/20 Lubliana str. O. Gudushauri National Medical Center, 3rd floor. Tbilisi, Georgia.
⁷ Infectious Diseases, AIDS and Clinical Immunology Research Center, 16 Kazbegi Ave. Tbilisi 0162, Georgia.
⁸ Clinic Mrcheveli, 9 Kazbegi Ave. Tbilisi 0162, Georgia.
⁹ Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: lgi1@cdc.gov.
¹⁰ Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: hij9@cdc.gov.
¹¹ Foundation for Innovative New Diagnostics, Campus Biotech, 9 Chemin des Mines, 1202 Geneva, Switzerland. Electronic address: Sonjelle.Shilton@finddx.org.
¹² Foundation for Innovative New Diagnostics, Campus Biotech, 9 Chemin des Mines, 1202 Geneva, Switzerland. Electronic address: maia.japaridze@finddx.org.
¹³ Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: fma0@cdc.gov.

Abstract

Background: Georgia launched national HCV elimination program in 2015. PWID may experience barriers to accessing HCV care. To improve linkage to care among PWID, pilot program to integrate HCV treatment with HR services at opiate substitution therapy (OST) centers and needle syringe program (NSP) sites was initiated. Our study aimed to assess satisfaction of patients with integrated HCV treatment services at HR centers.

Methods: Survey was conducted among convenience sample of patients receiving HCV treatment at 5 integrated care sites and 4 specialized clinics not providing HR services. Simplified pre-treatment diagnostic algorithm and treatment monitoring procedure was introduced for HCV treatment programs at OST/NSP centers which includes fewer pre-treatment and monitoring tests compared to standard algorithm.

Results: In total, 358 patients participated in the survey - 48.6% receiving HCV treatment at the specialized clinics while 51.4% at HR site with integrated treatment. Similar proportions of surveyed patients at HR sites (88.0%) and clinics (84.5%) stated that they did not face any barriers to enrollment in the elimination program. Most patients from HR pilot sites and specialized clinics stated that they received comprehensive information about the treatment (98.4% vs 94.3%; p<0.010). 95% of respondents at both sites were confident that confidentiality was completely protected during treatment. Higher proportion of patients at pilot sites thought that HCV treatment services provided at facility were good compared to those from the specialized clinics (85.3% vs 81.0%). We found significant difference in the time to treatment, measured as average time from viremia testing to administration of first dose of HCV medication: 42.9% of patients at pilot sites vs 4.6% at specialized clinics received the first dose of medication within two weeks.

Conclusion: Quality of services and perceived satisfaction of patients receiving treatment, suggests that integration of HCV treatment with HR services is feasible.

Keywords: HCV; Harm reduction; Integration; Patient satisfaction.

Publication types

Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Georgia
Harm Reduction
Hepatitis C* / drug therapy
Humans
Needle-Exchange Programs
Opiate Substitution Treatment
Patient Satisfaction
Substance Abuse, Intravenous* / drug therapy
Surveys and Questionnaires

Grants and funding

CC999999/ImCDC/Intramural CDC HHS/United States