Telehealth Could Address HCV Care Barriers, Expand Treatment for People Who Inject Drugs

New research suggests telehealth may help address barriers to hepatitis C virus (HCV) care among people who use drugs (PWUD), offering patient perspectives on intervention design and service delivery to optimize treatment in this high-risk population.

Findings from 9 focus group sessions conducted among PWUD in Greece were presented at The Liver Meeting 2024 from the American Association for the Study of Liver Diseases (AASLD) by Zoi Papalamprakopoulou, MD, a research fellow at the University at Buffalo.

“In the realm of healthcare digitalization, telehealth offers a convenient alternative to traditional in person appointments, reducing geographical and temporal barriers to care,” Papalamprakopoulou explained in an interview with HCPLive. “Telehealth offers the potential to improve healthcare access, not only for people living in rural areas where both substance use and hepatitis are on the rise, but also for individuals who may not engage with the traditional healthcare system.”

Despite the availability of highly effective HCV treatment, PWUD often face barriers to accessing care, largely attributed to stigma, healthcare system mistrust, and geographical obstacles. Telehealth may offer a viable option to overcome these barriers and help facilitate care in this patient population. Thus, understanding patient perceptions of this healthcare delivery modality are essential for informing its implementation in clinical practice.

Study results highlighted 3 main themes that emerged from the focus group discussions among 57 adults with a history of injection drug use and current internet access, including:

• High internet utilization for healthcare-related activities among PWUD
• Highlighting telehealth benefits despite access obstacles and PWUD concerns about diagnostic accuracy
• Approaches to overcome access obstacles and build digital trust

Investigators noted participants were largely telehealth-inexperienced but viewed telehealth positively and recognized its benefits. However, some participants expressed concerns about diagnostic accuracy in the absence of a physical examination.

In order to address technology accessibility barriers and improve digital trust, participants suggested partnering with community organizations equipped with telehealth infrastructure, scheduling an initial in-person provider appointment, and promoting virtual eye contact.

“These insights and practical recommendations, directly from the population's perspective, could guide the successful implementation of patient-centered telehealth-based hepatitis C interventions,” Papalamprakopoulou said, noting she would like to see additional research conducted in different community organizations and rural areas as well as in combination with the recently approved point-of-care hepatitis C RNA test.

Editors’ note: Papalamprakopoulou reports disclosures with Troup Fund of the Kaleida Health Foundation (PCORI Award) and Gilead FOCUS program.

Reference

^{Papalamprakopoulou Z, Ntagianta E, Triantafyllou V, et al. Telehealth to increase healthcare access; perspectives of people who use drugs. Paper presented at: AASLD’s The Liver Meeting 2024. San Diego, California. November 15-19, 2024.}