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A randomized trial of a hepatitis care coordination model in methadone maintenance treatment

  • Author(s): Masson, CL
  • Delucchi, KL
  • McKnight, C
  • Hettema, J
  • Khalili, M
  • Min, A
  • Jordan, AE
  • Pepper, N
  • Hall, J
  • Hengl, NS
  • Young, C
  • Shopshire, MS
  • Manuel, JK
  • Coffin, L
  • Hammer, H
  • Shapiro, B
  • Seewald, RM
  • Bodenheimer, HC
  • Sorensen, JL
  • Des Jarlais, DC
  • Perlman, DC
  • et al.
Abstract

Objectives. We 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. Methods. We 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. Results. Compared 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). Conclusions. Hepatitis care coordination was efficacious in increasing adherence to HAV-HBV vaccination and HCV clinical evaluation among methadone patients.

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