September 10, 2013

American Journal of Public Health
October 2013, Vol. 103, No. 10 : pp. e81-e88

Carmen L. Masson, Kevin L. Delucchi, Courtney McKnight, Jennifer Hettema, Mandana Khalili, Albert Min, Ashly E. Jordan, Nicole Pepper, Jessica Hall, Nicholas S. Hengl, Christopher Young, Michael S. Shopshire, Jennifer K. Manuel, Lara Coffin, Hali Hammer, Bradley Shapiro, Randy M. Seewald, Henry C. BodenheimerJr, James L. Sorensen, Don C. Des Jarlais, and David C. Perlman

(doi: 10.2105/AJPH.2013.301458)

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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