Treating Hepatitis C in Addiction Medicine and Primary Care through a Telehealth model; a Curriculum

Abstract

Background The American Association for the Study of Liver Disease created a simplified cascade for the treatment of non-cirrhotic, treatment naïve, adults with hepatitis C. Given the expanded guidelines, a novel curriculum was implemented to train nonspecialist providers. With the need for immediate access to hepatitis C treatment, in part due to the increase in IV drug use creating a new cohort of those infected, this project assessed the efficacy of a curriculum designed to train nonspecialist providers to treat hepatitis C following CDC and AASLD simplified guidelines. Methods The educational curriculum and survey setting was an addiction medicine telehealth-based practice operating in several states including New Jersey, Michigan, Texas, Ohio, California, Alaska, and Florida. The providers included physician assistants and nurse practitioners who ranged from newly graduated to over twenty years’ experience. The survey had 23 questions assessing points on treating hepatitis C, past experiences, comfort level and feelings about the curriculum and support. Results The 37 survey participants were 85% who identified as female and 15% who identified as male, 67% of which identified as White with the overall age distribution being varied (majority between 34-45). 46% of participants stated they felt uncomfortable or very uncomfortable about treating hepatitis C before completing the curriculum and 69% of the respondents had never treated hepatitis C. After completing the training 76% remarked that they felt either comfortable or very comfortable treating hepatitis C. Conclusion With the colliding epidemics, it is imperative to have trained providers who can treat hepatitis C. Since there are only 20,000 specialists, the addition of nonspecialist providers removes barriers to access and timely care. The follow-up survey assessed a compelling change in comfort level after doing the training, which supports the integration of the American Association for the Study of Liver Disease simplified guidelines in various types of practices. Curriculums designed to treat hepatis C and utilize telehealth systems will help decrease barriers and reduce the public health risk of spreading new infections.