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Talal AH, Dharia A, Kapadia SN, Tyson GL, Birch S, Zerzan-Thul J, Sullivan D, Britton E, Wethington E, Gonzalez CJ, Fliss M, Mizroch B, McCall F, Lloyd AR, Shapiro MF, Franco R. Hepatitis C Virus Elimination Programs in Louisiana and Washington: Importance of Screening and Surveillance Systems. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024; 30:208-212. [PMID: 37594263 PMCID: PMC10833194 DOI: 10.1097/phh.0000000000001808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
The US government has established a national goal of hepatitis C virus (HCV) elimination by 2030. To date, most HCV elimination planning and activity have been at the state level. Fifteen states presently have publicly available HCV elimination plans. In 2019, Louisiana and Washington were the first states to initiate 5-year funded HCV elimination programs. These states differ on motivation for pursuing HCV elimination and ranking on several indicators. Simultaneously, however, they have emphasized several similar elimination components including HCV screening promotion through public awareness, screening expansion, surveillance enhancement (including electronic reporting and task force development), and harm reduction. The 13 other states with published elimination plans have proposed the majority of the elements identified by Louisiana and Washington, but several have notable gaps. Louisiana's and Washington's comprehensive plans, funding approaches, and programs provide a useful framework that can move states and the nation toward HCV elimination.
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Affiliation(s)
- Andrew H. Talal
- Division of Gastroenterology, Hepatology and Nutrition, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York (Drs Talal and Dharia); Divisions of Infectious Diseases (Dr Kapadia) and General Internal Medicine (Drs Gonzalez and Shapiro), Weill Cornell Medicine, New York, New York; Louisiana Department of Health, New Orleans, Louisiana (Drs Tyson, Mizroch, and McCall and Ms Britton); Washington State Healthcare Authority, Olympia, Washington (Drs Sullivan and Zerzan-Thul and Mss Birch and Fliss); Cornell University, Ithaca, New York (Dr Wethington); and Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama (Drs Lloyd and Franco)
| | - Arpan Dharia
- Division of Gastroenterology, Hepatology and Nutrition, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York (Drs Talal and Dharia); Divisions of Infectious Diseases (Dr Kapadia) and General Internal Medicine (Drs Gonzalez and Shapiro), Weill Cornell Medicine, New York, New York; Louisiana Department of Health, New Orleans, Louisiana (Drs Tyson, Mizroch, and McCall and Ms Britton); Washington State Healthcare Authority, Olympia, Washington (Drs Sullivan and Zerzan-Thul and Mss Birch and Fliss); Cornell University, Ithaca, New York (Dr Wethington); and Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama (Drs Lloyd and Franco)
| | - Shashi N. Kapadia
- Division of Gastroenterology, Hepatology and Nutrition, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York (Drs Talal and Dharia); Divisions of Infectious Diseases (Dr Kapadia) and General Internal Medicine (Drs Gonzalez and Shapiro), Weill Cornell Medicine, New York, New York; Louisiana Department of Health, New Orleans, Louisiana (Drs Tyson, Mizroch, and McCall and Ms Britton); Washington State Healthcare Authority, Olympia, Washington (Drs Sullivan and Zerzan-Thul and Mss Birch and Fliss); Cornell University, Ithaca, New York (Dr Wethington); and Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama (Drs Lloyd and Franco)
| | - Gia L. Tyson
- Division of Gastroenterology, Hepatology and Nutrition, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York (Drs Talal and Dharia); Divisions of Infectious Diseases (Dr Kapadia) and General Internal Medicine (Drs Gonzalez and Shapiro), Weill Cornell Medicine, New York, New York; Louisiana Department of Health, New Orleans, Louisiana (Drs Tyson, Mizroch, and McCall and Ms Britton); Washington State Healthcare Authority, Olympia, Washington (Drs Sullivan and Zerzan-Thul and Mss Birch and Fliss); Cornell University, Ithaca, New York (Dr Wethington); and Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama (Drs Lloyd and Franco)
| | - Susan Birch
- Division of Gastroenterology, Hepatology and Nutrition, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York (Drs Talal and Dharia); Divisions of Infectious Diseases (Dr Kapadia) and General Internal Medicine (Drs Gonzalez and Shapiro), Weill Cornell Medicine, New York, New York; Louisiana Department of Health, New Orleans, Louisiana (Drs Tyson, Mizroch, and McCall and Ms Britton); Washington State Healthcare Authority, Olympia, Washington (Drs Sullivan and Zerzan-Thul and Mss Birch and Fliss); Cornell University, Ithaca, New York (Dr Wethington); and Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama (Drs Lloyd and Franco)
| | - Judy Zerzan-Thul
- Division of Gastroenterology, Hepatology and Nutrition, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York (Drs Talal and Dharia); Divisions of Infectious Diseases (Dr Kapadia) and General Internal Medicine (Drs Gonzalez and Shapiro), Weill Cornell Medicine, New York, New York; Louisiana Department of Health, New Orleans, Louisiana (Drs Tyson, Mizroch, and McCall and Ms Britton); Washington State Healthcare Authority, Olympia, Washington (Drs Sullivan and Zerzan-Thul and Mss Birch and Fliss); Cornell University, Ithaca, New York (Dr Wethington); and Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama (Drs Lloyd and Franco)
| | - Donna Sullivan
- Division of Gastroenterology, Hepatology and Nutrition, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York (Drs Talal and Dharia); Divisions of Infectious Diseases (Dr Kapadia) and General Internal Medicine (Drs Gonzalez and Shapiro), Weill Cornell Medicine, New York, New York; Louisiana Department of Health, New Orleans, Louisiana (Drs Tyson, Mizroch, and McCall and Ms Britton); Washington State Healthcare Authority, Olympia, Washington (Drs Sullivan and Zerzan-Thul and Mss Birch and Fliss); Cornell University, Ithaca, New York (Dr Wethington); and Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama (Drs Lloyd and Franco)
| | - Elizabeth Britton
- Division of Gastroenterology, Hepatology and Nutrition, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York (Drs Talal and Dharia); Divisions of Infectious Diseases (Dr Kapadia) and General Internal Medicine (Drs Gonzalez and Shapiro), Weill Cornell Medicine, New York, New York; Louisiana Department of Health, New Orleans, Louisiana (Drs Tyson, Mizroch, and McCall and Ms Britton); Washington State Healthcare Authority, Olympia, Washington (Drs Sullivan and Zerzan-Thul and Mss Birch and Fliss); Cornell University, Ithaca, New York (Dr Wethington); and Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama (Drs Lloyd and Franco)
| | - Elaine Wethington
- Division of Gastroenterology, Hepatology and Nutrition, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York (Drs Talal and Dharia); Divisions of Infectious Diseases (Dr Kapadia) and General Internal Medicine (Drs Gonzalez and Shapiro), Weill Cornell Medicine, New York, New York; Louisiana Department of Health, New Orleans, Louisiana (Drs Tyson, Mizroch, and McCall and Ms Britton); Washington State Healthcare Authority, Olympia, Washington (Drs Sullivan and Zerzan-Thul and Mss Birch and Fliss); Cornell University, Ithaca, New York (Dr Wethington); and Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama (Drs Lloyd and Franco)
| | - Christopher J. Gonzalez
- Division of Gastroenterology, Hepatology and Nutrition, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York (Drs Talal and Dharia); Divisions of Infectious Diseases (Dr Kapadia) and General Internal Medicine (Drs Gonzalez and Shapiro), Weill Cornell Medicine, New York, New York; Louisiana Department of Health, New Orleans, Louisiana (Drs Tyson, Mizroch, and McCall and Ms Britton); Washington State Healthcare Authority, Olympia, Washington (Drs Sullivan and Zerzan-Thul and Mss Birch and Fliss); Cornell University, Ithaca, New York (Dr Wethington); and Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama (Drs Lloyd and Franco)
| | - Mary Fliss
- Division of Gastroenterology, Hepatology and Nutrition, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York (Drs Talal and Dharia); Divisions of Infectious Diseases (Dr Kapadia) and General Internal Medicine (Drs Gonzalez and Shapiro), Weill Cornell Medicine, New York, New York; Louisiana Department of Health, New Orleans, Louisiana (Drs Tyson, Mizroch, and McCall and Ms Britton); Washington State Healthcare Authority, Olympia, Washington (Drs Sullivan and Zerzan-Thul and Mss Birch and Fliss); Cornell University, Ithaca, New York (Dr Wethington); and Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama (Drs Lloyd and Franco)
| | - Brandon Mizroch
- Division of Gastroenterology, Hepatology and Nutrition, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York (Drs Talal and Dharia); Divisions of Infectious Diseases (Dr Kapadia) and General Internal Medicine (Drs Gonzalez and Shapiro), Weill Cornell Medicine, New York, New York; Louisiana Department of Health, New Orleans, Louisiana (Drs Tyson, Mizroch, and McCall and Ms Britton); Washington State Healthcare Authority, Olympia, Washington (Drs Sullivan and Zerzan-Thul and Mss Birch and Fliss); Cornell University, Ithaca, New York (Dr Wethington); and Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama (Drs Lloyd and Franco)
| | - Frederic McCall
- Division of Gastroenterology, Hepatology and Nutrition, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York (Drs Talal and Dharia); Divisions of Infectious Diseases (Dr Kapadia) and General Internal Medicine (Drs Gonzalez and Shapiro), Weill Cornell Medicine, New York, New York; Louisiana Department of Health, New Orleans, Louisiana (Drs Tyson, Mizroch, and McCall and Ms Britton); Washington State Healthcare Authority, Olympia, Washington (Drs Sullivan and Zerzan-Thul and Mss Birch and Fliss); Cornell University, Ithaca, New York (Dr Wethington); and Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama (Drs Lloyd and Franco)
| | - Audrey R. Lloyd
- Division of Gastroenterology, Hepatology and Nutrition, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York (Drs Talal and Dharia); Divisions of Infectious Diseases (Dr Kapadia) and General Internal Medicine (Drs Gonzalez and Shapiro), Weill Cornell Medicine, New York, New York; Louisiana Department of Health, New Orleans, Louisiana (Drs Tyson, Mizroch, and McCall and Ms Britton); Washington State Healthcare Authority, Olympia, Washington (Drs Sullivan and Zerzan-Thul and Mss Birch and Fliss); Cornell University, Ithaca, New York (Dr Wethington); and Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama (Drs Lloyd and Franco)
| | - Martin F. Shapiro
- Division of Gastroenterology, Hepatology and Nutrition, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York (Drs Talal and Dharia); Divisions of Infectious Diseases (Dr Kapadia) and General Internal Medicine (Drs Gonzalez and Shapiro), Weill Cornell Medicine, New York, New York; Louisiana Department of Health, New Orleans, Louisiana (Drs Tyson, Mizroch, and McCall and Ms Britton); Washington State Healthcare Authority, Olympia, Washington (Drs Sullivan and Zerzan-Thul and Mss Birch and Fliss); Cornell University, Ithaca, New York (Dr Wethington); and Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama (Drs Lloyd and Franco)
| | - Ricardo Franco
- Division of Gastroenterology, Hepatology and Nutrition, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York (Drs Talal and Dharia); Divisions of Infectious Diseases (Dr Kapadia) and General Internal Medicine (Drs Gonzalez and Shapiro), Weill Cornell Medicine, New York, New York; Louisiana Department of Health, New Orleans, Louisiana (Drs Tyson, Mizroch, and McCall and Ms Britton); Washington State Healthcare Authority, Olympia, Washington (Drs Sullivan and Zerzan-Thul and Mss Birch and Fliss); Cornell University, Ithaca, New York (Dr Wethington); and Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama (Drs Lloyd and Franco)
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Tsui J, Gojic A, Pierce K, Tung E, Connolly N, Radick A, Hunt R, Sandvold R, Taber K, Ninburg M, Kubiniec R, Scott J, Hansen R, Stekler J, Austin E, Williams E, Glick S. Pilot study of a community pharmacist led program to treat hepatitis C virus among people who inject drugs. DRUG AND ALCOHOL DEPENDENCE REPORTS 2024; 10:100213. [PMID: 38261893 PMCID: PMC10796962 DOI: 10.1016/j.dadr.2023.100213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/25/2024]
Abstract
Background People who inject drugs (PWID) are a key population for treatment with direct-acting antiviral medications (DAAs) to eliminate hepatitis C virus (HCV). We developed a Pharmacist, Physician, and Patient Navigator Collaborative Care Model (PPP-CCM) for delivery of HCV treatment; this study describes clinical outcomes related to HCV treatment (initial evaluation, treatment initiation, completion, and cure), as well as patient satisfaction. Methods We conducted a single-arm prospective pilot study of adult PWID living with HCV. Participants completed baseline and six-month follow-up surveys, and treatment and outcomes were abstracted from electronic health records. Primary outcome was linkage to pharmacist for HCV evaluation; secondary outcomes included DAA initiation, completion, and cure, as well as patient-reported satisfaction. Results Of the 40 PWID enrolled, mean age was 43.6 years, 12 (30 %) were female, 20 (50 %) were non-white, and 15 (38 %) were unhoused. Thirty-eight (95 %) were successfully linked to the pharmacist for initial evaluation. Of those, 21/38 (55 %) initiated DAAs, and 16/21 (76 %) completed treatment. Among those completing treatment who had viral load data to document whether they achieved "sustained virologic response", i.e. cure, 10/11 (91 %) were found to be cured. There was high satisfaction with 100 % responding "agree or strongly agree" that they had a positive experience with the pharmacist. Conclusion Nearly all participants in this pilot were successfully linked to the pharmacist for evaluation, and more than half were started on DAAs; results provide preliminary evidence of feasibility of pharmacist-led models of HCV treatment for PWID. Clinicaltrialsgov registration number NCT04698629.
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Affiliation(s)
- J.I. Tsui
- Department of Medicine, University of Washington School of Medicine, Division of General Internal Medicine University of Washington, Seattle, WA, United States
| | - A.J. Gojic
- Department of Medicine, University of Washington School of Medicine, Division of General Internal Medicine University of Washington, Seattle, WA, United States
| | - K.A. Pierce
- Kelley-Ross Pharmacy Group, Seattle, WA, United States
| | - E.L. Tung
- Kelley-Ross Pharmacy Group, Seattle, WA, United States
- Department of Pharmacy, University of Washington, Seattle, WA, United States
| | - N.C. Connolly
- Department of Medicine, University of Washington School of Medicine, Division of General Internal Medicine University of Washington, Seattle, WA, United States
| | - A.C. Radick
- Department of Medicine, University of Washington School of Medicine, Division of General Internal Medicine University of Washington, Seattle, WA, United States
| | - R.R. Hunt
- Des Moines University College of Osteopathic Medicine, Des Moines, IA, United States
| | - R. Sandvold
- Hepatitis Education Project, Seattle, WA, United States
| | - K. Taber
- Hepatitis Education Project, Seattle, WA, United States
| | - M. Ninburg
- Hepatitis Education Project, Seattle, WA, United States
| | - R.H. Kubiniec
- Evergreen Treatment Services, Seattle, WA, United States
| | - J.D. Scott
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle WA, United States
| | - R.N. Hansen
- Kelley-Ross Pharmacy Group, Seattle, WA, United States
- Department of Pharmacy, University of Washington, Seattle, WA, United States
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - J.D. Stekler
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle WA, United States
| | - E.J. Austin
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - E.C. Williams
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
- Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound, Seattle WA, United States
| | - S.N. Glick
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle WA, United States
- HIV/STI/HCV Program, Public Health - Seattle & King County, Seattle WA, United States
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