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

Am J Public Health. 2013 Oct;103(10):e81-8. doi: 10.2105/AJPH.2013.301458. Epub 2013 Aug 15.

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.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Confidence Intervals
  • Female
  • Hepatitis A / prevention & control*
  • Hepatitis B / prevention & control*
  • Humans
  • Male
  • Methadone / therapeutic use*
  • Middle Aged
  • New York City
  • Opiate Substitution Treatment*
  • Outcome Assessment, Health Care
  • Patient Compliance / statistics & numerical data
  • San Francisco
  • Vaccination*

Substances

  • Methadone