1. A randomized trial of a hepatitis care coordination model in methadone maintenance treatment.
- Author
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Masson, Carmen L, Delucchi, Kevin L, McKnight, Courtney, Hettema, Jennifer, Khalili, Mandana, Min, Albert, Jordan, Ashly E, Pepper, Nicole, Hall, Jessica, Hengl, Nicholas S, Young, Christopher, Shopshire, Michael S, Manuel, Jennifer K, Coffin, Lara, Hammer, Hali, Shapiro, Bradley, Seewald, Randy M, Bodenheimer, Henry C, Sorensen, James L, Des Jarlais, Don C, and Perlman, David C
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Chronic Liver Disease and Cirrhosis ,Clinical Trials and Supportive Activities ,Hepatitis - C ,Prevention ,Immunization ,Infectious Diseases ,Comparative Effectiveness Research ,Hepatitis - B ,Vaccine Related ,Digestive Diseases ,Emerging Infectious Diseases ,Hepatitis ,Clinical Research ,Liver Disease ,Infection ,Good Health and Well Being ,Adult ,Confidence Intervals ,Female ,Hepatitis A ,Hepatitis B ,Humans ,Male ,Methadone ,Middle Aged ,New York City ,Opiate Substitution Treatment ,Outcome Assessment ,Health Care ,Patient Compliance ,San Francisco ,Vaccination ,Medical and Health Sciences ,Public Health ,Biomedical and clinical sciences ,Health sciences - Abstract
ObjectivesWe evaluated the efficacy of a hepatitis care coordination intervention to improve linkage to hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccination and clinical evaluation of hepatitis C virus (HCV) infection among methadone maintenance patients.MethodsWe conducted a randomized controlled trial of 489 participants from methadone maintenance treatment programs in San Francisco, California, and New York City from February 2008 through June 2011. We randomized participants to a control arm (n = 245) and an intervention arm (n = 244), which included on-site screening, motivational-enhanced education and counseling, on-site vaccination, and case management services.ResultsCompared with the control group, intervention group participants were significantly more likely (odds ratio [OR] = 41.8; 95% confidence interval [CI] = 19.4, 90.0) to receive their first vaccine dose within 30 days and to receive an HCV evaluation within 6 months (OR = 4.10; 95% CI = 2.35, 7.17). A combined intervention adherence outcome that measured adherence to HAV-HBV vaccination, HCV evaluation, or both strongly favored the intervention group (OR = 8.70; 95% CI = 5.56, 13.61).ConclusionsHepatitis care coordination was efficacious in increasing adherence to HAV-HBV vaccination and HCV clinical evaluation among methadone patients.
- Published
- 2013