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Journal of Community Health

, Volume 44, Issue 1, pp 169–171 | Cite as

Successful Implementation of a Shared Medical Appointment Model for Hepatitis C Treatment at a Community Health Center

  • Jacqueline HodgesEmail author
  • Jessica Reyes
  • Joyce Campbell
  • Wesley Klein
  • Alysse Wurcel
Original Paper

Abstract

Highly efficacious direct acting antiviral (DAA) therapy for treatment of Hepatitis C Virus (HCV) infection is largely inaccessible to communities facing a shortage of available specialist providers. Though less demanding than previous interferon regimens, DAA therapy requires patients to adhere to 8–12 weeks of daily treatment, which can be challenging for some patient populations. Duffy Health Center, located on Cape Cod, Massachusetts, provides integrated medical, mental health and case management services to people who are homeless or at risk for homelessness. The goal of this manuscript is to evaluate the outcomes of treatment of HCV infection with a shared medical appointment (SMA) model. The primary outcome was sustained virologic response (SVR-12), or HCV RNA ≤ 15 IU/mL at 12 weeks post-treatment. There were 102 patients recruited, with a total of 104 treatments administered. Over three-fourths of patients who attended one SMA visit (78 of 102) continued in SMA for the duration of treatment. Of these patients opting for SMA, 99% (77 of 78) completed the full treatment course, and 91% (71 of 78) of SMA patients achieved SVR-12. DAA therapy provided by non-specialist providers using the SMA model yielded comparable response rates to those achieved by specialist providers, and has the potential to substantially increase access to HCV treatment for patient populations within high-risk communities.

Keywords

Shared medical appointment Hepatitis C Task shifting Peer support Direct acting antiviral therapy 

Notes

Funding

Funding was provided by: Health Resources and Services Administration (Grant No. H80CS00271), National Institutes of Health (R25DA037190, 1KL2TR002545-01).

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Tufts University School of MedicineBostonUSA
  2. 2.Duffy Health CenterHyannisUSA
  3. 3.Tufts Medical CenterBostonUSA

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