ArticleThe American journal on addictions2026
Improving access to direct acting antivirals via a multimodal integrated care program in an addiction medicine clinic.
Article in The American journal on addictions, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND AND
objectivesInjection drug use is a driver of hepatitis C virus (HCV) transmission, thus integrating HCV care into addiction care is likely necessary for HCV elimination. Here we describe how we integrated HCV care into our addiction medicine (AM) clinic and evaluate its effect on HCV treatment.
methodsIntegrated care involves HCV screening and treatment with either DAA prescription directly in AM clinic or via telemedicine with an infectious diseases (ID) specialist. Using retrospective chart review, we assessed if the program affected rates of direct-acting antivirals (DAA) initiation, DAA completion, and sustained virological response (SVR).
resultsAmong 72 treatment naïve patients, the rate of DAA initiation increased after integrated care (HR 2.21, 95% CI 1.05-4.66), but rates of DAA completion or SVR did not significantly increase. Integrated care was associated with more DAA prescriptions (0.6 vs. 0 prescriptions per month, p = .004) and decreased referrals to hepatology (0.2 vs. 1 referrals per month, p = .001). Compared to referring patients to hepatology, prescribing DAAs in AM clinic was associated with higher rates of DAA initiation (HR 42.46; 95% CI: 15.25-118.24) and completion (HR 8.33; 95% CI: 2.76-25.16). DISCUSSION AND
conclusionsAn integrated care program that involved both in-person and telemedicine options improve access to DAA therapy. Enhancing interprofessional collaboration and expanding telemedicine services offers a practical model for strengthening HCV care delivery. SCIENTIFIC SIGNIFICANCE: This study demonstrates a practical approach to integrating HCV care into addiction treatment through development of inter-professional collaboration between healthcare specialties.
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