- The State University of New York is getting a $7 million grant to test the effectiveness of telemedicine in treating certain patients with the hepatitis C virus.
The grant, from the Patient-Centered Outcomes Research Institute (PCORI), targets an elusive and especially underserved population: drug users. Some 5 million people in the U.S. are infected by HCV, with a large percentage contracting the virus through drug use and as many as 70 percent classified as chronically infected. Without proper treatment, HCV can lead to chronic liver disease, liver fibrosis, cirrhosis, liver cancer and death.
The five-year project, to be conducted at 12 methadone clinics throughout the state, will compare a standard regimen of in-person care with treatment by video visits. The telemedicine option will be randomly and gradually introduced over the project’s lifespan.
The SUNY project is one of several efforts around the country to bring mHealth to bear not only on chronic conditions, but on those with addiction issues. Whether through a videoconference platform that brings a doctor together with an addict who doesn’t want to be in a doctor’s office, or via a text messaging or smartphone-based platform that offers frequent touches between a patient and a caregiver, the idea is to make the patient comfortable with the care plan, improving engagement and adherence.
The current standard of treatment for drug users with HCV involves a visit to a methadone clinic, followed by a referral to a liver specialist for continued care. Many patients ignore those referrals, often because they don’t trust doctors, or they’ll follow through with an appointment but don’t follow a prescribed care plan. Researchers are hoping that a video visit arranged at the methadone clinic improves that level of trust, and thus boosts patient adherence to a care management plan and clinical outcomes.
The project will measure the rate of virus eradication 12 weeks after completing HCV treatment, as well as patient satisfaction, treatment completion rates and treatment adherence rates.
“As current approaches for HCV treatment of people recovering from addiction are highly unsuccessful, new models for HCV care in this population are needed,” the project summary states on the PCORI website. “The major goal of our study is to provide such a model.”
The project leader is Andrew Talal, MD, MPH, a professor of medicine and director of the Center for Clinical Care and Research in Liver Disease at the Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo.