Evidence map›Paper›PMID 35998029›Full record

ArticleInteractive journal of medical research2022

Integrating Hepatitis C Care for Opioid Substitution Treatment Patients Attending General Practice: Feasibility, Clinical, and Cost-Effectiveness Analysis.

Geoff McCombe, Davina Swan, John S Lambert, Eileen O'Connor, Zoe Ward, Peter Vickerman, Gordana Avramovic, Des Crowley, Willard Tinago, Nyashadzaishe Mafirakureva and 1 more

Open access · goldAbstract read
In one paragraph

Article in Interactive journal of medical research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 41% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 2 countries.

Geoff McCombeSchool of Medicine, University College Dublin, Dublin, Ireland.ORCID https://orcid.org/0000-0003-4898-3459
Davina SwanSchool of Medicine, University College Dublin, Dublin, Ireland.ORCID https://orcid.org/0000-0003-0694-7230
John S LambertSchool of Medicine, University College Dublin, Dublin, Ireland.ORCID https://orcid.org/0000-0001-5404-2415
Eileen O'ConnorSchool of Medicine, University College Dublin, Dublin, Ireland.ORCID https://orcid.org/0000-0002-9292-490X
Zoe WardBristol Population Health Science Institute, Bristol Medical School, University of Bristol, Bristol, United Kingdom.ORCID https://orcid.org/0000-0002-0268-988X
Peter VickermanBristol Population Health Science Institute, Bristol Medical School, University of Bristol, Bristol, United Kingdom.ORCID https://orcid.org/0000-0002-8291-5890
Gordana AvramovicSchool of Medicine, University College Dublin, Dublin, Ireland.ORCID https://orcid.org/0000-0001-9610-6472
Des CrowleyHealth Service Executive, Dublin, Ireland.ORCID https://orcid.org/0000-0002-8491-9596
Willard TinagoSchool of Medicine, University College Dublin, Dublin, Ireland.ORCID https://orcid.org/0000-0001-6858-9606
Nyashadzaishe MafirakurevaBristol Population Health Science Institute, Bristol Medical School, University of Bristol, Bristol, United Kingdom.ORCID https://orcid.org/0000-0001-9775-6581
Walter CullenSchool of Medicine, University College Dublin, Dublin, Ireland.ORCID https://orcid.org/0000-0003-1838-5052
University College Dublin · IEUniversity of Bristol · GBHealth Service Executive · IE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHepatitis C virus (HCV) infection is common among people who inject drugs, yet well-described barriers mean that only a minority have accessed HCV treatment. Recent developments in HCV diagnosis and treatment facilitate innovative approaches to HCV care that improve access to, and uptake of, care by people who inject drugs.

objectiveThis study aims to examine feasibility, acceptability, likely clinical effectiveness, and cost-effectiveness of an integrated model of HCV care for patients receiving opioid substitution treatment in general practice.

methodsA pre- and postintervention design with an embedded economic analysis was used to establish the feasibility, acceptability, and clinical and cost-effectiveness of a complex intervention to optimize HCV identification and linkage to HCV treatment among patients prescribed methadone in primary care. The "complex intervention" comprised general practitioner (GP)/practice staff education, nurse-led clinical support, and enhanced community-based HCV assessment of patients. General practices in North Dublin were recruited from the professional networks of the research team and from GPs who attended educational sessions.

resultsA total of 135 patients from 14 practices participated. Follow-up data were collected 6 months after intervention from 131 (97.0%) patients. With regard to likely clinical effectiveness, among patients with HCV antibody positivity, there was a significant increase in the proportions of patients who had a liver FibroScan (17/101, 16.8% vs 52/100, 52.0%; P<.001), had attended hepatology/infectious diseases services (51/101, 50.5% vs 61/100 61.0%; P=.002), and initiated treatment (20/101, 19.8% vs 30/100, 30.0%; P=.004). The mean incremental cost-effectiveness ratio of the intervention was €13,255 (US $13,965.14) per quality-adjusted life-year gained at current full drug list price (€39,729 [US $41,857.48] per course), which would be cost saving if these costs are reduced by 88%.

conclusionsThe complex intervention involving clinical support, access to assessment, and practitioner education has the potential to enhance patient care, improving access to assessment and treatment in a cost-effective manner.

Indexed as

hepatitis Cintegrated HCV carepeople who inject drugsprimary health care

Identifiers

PMID35998029
PMCPMC9449831
OpenAlexW4225638450

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.