Development, implementation, and feasibility of site-specific hepatitis C virus treatment workflows for treating vulnerable, high-risk populations: protocol of the Erase Hep C study — a prospective single-arm intervention trial
Abstract Background Hepatitis C virus (HCV) is the leading indication for liver transplantation and liver-related mortality. The development of direct-acting antivirals (DAA) and a simplified treatment algorithm with a > 97% cure rate should make global elimination of HCV an achievable goal. Yet,...
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | Pilot and Feasibility Studies |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40814-023-01311-4 |
| _version_ | 1797789890442690560 |
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| author | Anmol Desai Lauren O’Neal Kia Reinis Patrick Chang Cristal Brown Michael Stefanowicz Audrey Kuang Deepak Agrawal Darlene Bhavnani Tim Mercer |
| author_facet | Anmol Desai Lauren O’Neal Kia Reinis Patrick Chang Cristal Brown Michael Stefanowicz Audrey Kuang Deepak Agrawal Darlene Bhavnani Tim Mercer |
| author_sort | Anmol Desai |
| collection | DOAJ |
| description | Abstract Background Hepatitis C virus (HCV) is the leading indication for liver transplantation and liver-related mortality. The development of direct-acting antivirals (DAA) and a simplified treatment algorithm with a > 97% cure rate should make global elimination of HCV an achievable goal. Yet, vulnerable populations with high rates of HCV still have limited access to treatment. By designing locally contextualized site-specific HCV treatment workflows, we aim to cure HCV in vulnerable, high-risk populations, including people experiencing homelessness (PEH) and people who inject drugs (PWID), in Austin, TX, USA. Methods Our implementation science study will utilize a qualitative and design thinking approach to characterize patient and systemic barriers and facilitators to HCV treatment in vulnerable, high-risk populations seeking care across seven diverse primary care clinics serving PEHs and PWIDs. Qualitative interviews guided by the Practical, Robust Implementation and Sustainability Model (PRISM) framework will identify barriers and facilitators by leveraging knowledge and experience from both clinic staff and patients. Data synthesized using thematic analysis and design thinking will feed into workshops with clinic stakeholders for idea generation to design site-specific HCV treatment workflows. Providers will be trained on the use of a simplified HCV treatment algorithm with DAAs and clinic staff on the new site-specific HCV treatment workflows. These workflows will be implemented by the seven diverse primary care clinics serving vulnerable, high-risk populations. Implementation and clinical outcomes will be measured using data collected through interviews with staff as well as through medical chart review. Discussion Our study provides a model of how to contextualize and implement site-specific HCV treatment workflows targeting vulnerable, high-risk populations in other geographic locations. This model can be adopted for future implementation research programs aiming to develop and implement site-specific treatment workflows for vulnerable, high-risk populations and in primary care clinical settings for other disease states beyond just HCV. Trial registration Registered on ClinicalTrials.gov on July, 14, 2022. Identifier: NCT05460130 . |
| first_indexed | 2024-03-13T01:57:01Z |
| format | Article |
| id | doaj.art-0d1389335f88420f909a2dc2dc968b78 |
| institution | Directory Open Access Journal |
| issn | 2055-5784 |
| language | English |
| last_indexed | 2024-03-13T01:57:01Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Pilot and Feasibility Studies |
| spelling | doaj.art-0d1389335f88420f909a2dc2dc968b782023-07-02T11:07:46ZengBMCPilot and Feasibility Studies2055-57842023-05-019111210.1186/s40814-023-01311-4Development, implementation, and feasibility of site-specific hepatitis C virus treatment workflows for treating vulnerable, high-risk populations: protocol of the Erase Hep C study — a prospective single-arm intervention trialAnmol Desai0Lauren O’Neal1Kia Reinis2Patrick Chang3Cristal Brown4Michael Stefanowicz5Audrey Kuang6Deepak Agrawal7Darlene Bhavnani8Tim Mercer9Department of Population Health, The University of Texas at Austin Dell Medical SchoolThe University of Texas at Austin Dell Medical SchoolDepartment of Population Health, The University of Texas at Austin Dell Medical SchoolDepartment of Population Health, The University of Texas at Austin Dell Medical SchoolDepartment of Internal Medicine, The University of Texas at Austin Dell Medical SchoolDepartment of Population Health, The University of Texas at Austin Dell Medical SchoolDepartment of Population Health, The University of Texas at Austin Dell Medical SchoolDepartment of Internal Medicine, The University of Texas at Austin Dell Medical SchoolDepartment of Population Health, The University of Texas at Austin Dell Medical SchoolDepartment of Population Health, The University of Texas at Austin Dell Medical SchoolAbstract Background Hepatitis C virus (HCV) is the leading indication for liver transplantation and liver-related mortality. The development of direct-acting antivirals (DAA) and a simplified treatment algorithm with a > 97% cure rate should make global elimination of HCV an achievable goal. Yet, vulnerable populations with high rates of HCV still have limited access to treatment. By designing locally contextualized site-specific HCV treatment workflows, we aim to cure HCV in vulnerable, high-risk populations, including people experiencing homelessness (PEH) and people who inject drugs (PWID), in Austin, TX, USA. Methods Our implementation science study will utilize a qualitative and design thinking approach to characterize patient and systemic barriers and facilitators to HCV treatment in vulnerable, high-risk populations seeking care across seven diverse primary care clinics serving PEHs and PWIDs. Qualitative interviews guided by the Practical, Robust Implementation and Sustainability Model (PRISM) framework will identify barriers and facilitators by leveraging knowledge and experience from both clinic staff and patients. Data synthesized using thematic analysis and design thinking will feed into workshops with clinic stakeholders for idea generation to design site-specific HCV treatment workflows. Providers will be trained on the use of a simplified HCV treatment algorithm with DAAs and clinic staff on the new site-specific HCV treatment workflows. These workflows will be implemented by the seven diverse primary care clinics serving vulnerable, high-risk populations. Implementation and clinical outcomes will be measured using data collected through interviews with staff as well as through medical chart review. Discussion Our study provides a model of how to contextualize and implement site-specific HCV treatment workflows targeting vulnerable, high-risk populations in other geographic locations. This model can be adopted for future implementation research programs aiming to develop and implement site-specific treatment workflows for vulnerable, high-risk populations and in primary care clinical settings for other disease states beyond just HCV. Trial registration Registered on ClinicalTrials.gov on July, 14, 2022. Identifier: NCT05460130 .https://doi.org/10.1186/s40814-023-01311-4Hepatitis C virusHomelessnessIntravenous drug useImplementation scienceSimplified treatmentSite-specific treatment |
| spellingShingle | Anmol Desai Lauren O’Neal Kia Reinis Patrick Chang Cristal Brown Michael Stefanowicz Audrey Kuang Deepak Agrawal Darlene Bhavnani Tim Mercer Development, implementation, and feasibility of site-specific hepatitis C virus treatment workflows for treating vulnerable, high-risk populations: protocol of the Erase Hep C study — a prospective single-arm intervention trial Pilot and Feasibility Studies Hepatitis C virus Homelessness Intravenous drug use Implementation science Simplified treatment Site-specific treatment |
| title | Development, implementation, and feasibility of site-specific hepatitis C virus treatment workflows for treating vulnerable, high-risk populations: protocol of the Erase Hep C study — a prospective single-arm intervention trial |
| title_full | Development, implementation, and feasibility of site-specific hepatitis C virus treatment workflows for treating vulnerable, high-risk populations: protocol of the Erase Hep C study — a prospective single-arm intervention trial |
| title_fullStr | Development, implementation, and feasibility of site-specific hepatitis C virus treatment workflows for treating vulnerable, high-risk populations: protocol of the Erase Hep C study — a prospective single-arm intervention trial |
| title_full_unstemmed | Development, implementation, and feasibility of site-specific hepatitis C virus treatment workflows for treating vulnerable, high-risk populations: protocol of the Erase Hep C study — a prospective single-arm intervention trial |
| title_short | Development, implementation, and feasibility of site-specific hepatitis C virus treatment workflows for treating vulnerable, high-risk populations: protocol of the Erase Hep C study — a prospective single-arm intervention trial |
| title_sort | development implementation and feasibility of site specific hepatitis c virus treatment workflows for treating vulnerable high risk populations protocol of the erase hep c study a prospective single arm intervention trial |
| topic | Hepatitis C virus Homelessness Intravenous drug use Implementation science Simplified treatment Site-specific treatment |
| url | https://doi.org/10.1186/s40814-023-01311-4 |
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