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. 2023 Dec 14:29:100648.
doi: 10.1016/j.lana.2023.100648. eCollection 2024 Jan.

Implementation of a mobile health clinic framework for Hepatitis C virus screening and treatment: a descriptive study

Lior Rennert  1   2 , Kerry A Howard  1   2 , Caitlin M Kickham  3 , Fatih Gezer  1   2 , Ashley Coleman  4 , Prerana Roth  4   5   6 , Kristie Boswell  3 , Ronald W Gimbel  1   3 , Alain H Litwin  4   5   6
Affiliations

Implementation of a mobile health clinic framework for Hepatitis C virus screening and treatment: a descriptive study

Lior Rennert et al. Lancet Reg Health Am. .

Abstract

Background: Although treatment for Hepatitis C Virus (HCV) is effective, individuals face access barriers. The utility of mobile health clinics (MHC), effective mechanisms for providing healthcare to underserved populations, is understudied for HCV-related interventions. We aimed to describe implementation of, and factors associated with, screening and treatment via MHCs.

Methods: Clemson Rural Health implemented a novel MHC program to reach and treat populations at-risk for HCV with a focus on care for uninsured individuals. We examined HCV screening and treatment initiation/completion indicators between May 2021 and January 2023.

Findings: Among 607 individuals screened across 31 locations, 94 (15.5%) tested positive via antibody and viral load testing. Treatment initiation and completion rates were 49.6% and 86.0%, respectively. Among those screened, the majority were male (57.5%), White (61.3%; Black/Hispanic: 28.2%/7.7%), and without personal vehicle as primary transportation mode (54.4%). Injection drug use (IDU) was 27.2% and uninsured rate was 42.8%. Compared to HCV-negative, those infected included more individuals aged 30-44 (52.1% vs. 36.4%, p = 0.023), male (70.2% vs. 55.2%, p = 0.009), White (78.5% vs. 60.2%, p < 0.0001), without personal vehicle (58.5% vs. 43.5%, p = 0.028), IDU (83.7% vs. 21.0%, p < 0.0001), and uninsured (61.2% vs. 48.8%, p = 0.050). Uninsured rates were higher among those initiating compared to not initiating treatment (74.5% vs. 45.3%, p = 0.004).

Interpretation: The MHC framework successfully reaching its target population: at-risk individuals with access barriers to healthcare. The high HCV screening and treatment initiation/completion rates demonstrate the utility of MHCs as effective and acceptable intervention settings among historically difficult-to-treat populations.

Funding: Gilead Sciences, Inc., and SC Center for Rural and Primary Healthcare.

Keywords: Hepatitis C virus; Mobile health clinics; People who inject drugs; Underserved populations; Uninsured populations.

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Conflict of interest statement

The program was supported by Gilead Sciences, Inc., (IN-US-987-5892) with additional funding specifically for uninsured patients from South Carolina Center for Rural and Primary Healthcare (2015593). KB, RG, CMK, PR, and AHL received support from South Carolina Center for Rural and Primary Healthcare during this study. KB, CMK, and AC received support from Gilead Sciences, Inc., during this study. KB received support for leading a round table discussion at a conference from International Network on Health and Hepatitis in Substance Users, speaking on a panel at a conference from Gilead Sciences, Inc., and travel to a conference from International Network on Health and Hepatitis in Substance Users. LR and FG received support from the National Library of Medicine of the National Institutes of Health (R01 LM014193-01A1) during this study. The funders had no role in the design, conduct, reporting of the study, or decision to submit for publication. Payments were made to our institution. AHL has served on the advisory boards for Gilead Sciences, Inc., and AbbVie.

Figures

Fig. 1
Fig. 1
Diagram of the sequence of care at the MHCs for patients. Diagram shows patients screened, tested, and treated for HCV, including uptake of services by week of site visit, procedures for those testing positive, procedures for uninsured individuals, and MHC involvement in treatment and follow-up.
Fig. 2
Fig. 2
Maps of Upstate region MHC site visits. Maps showing number of people screened (a) and number of people with a detected current infection (b) in a visited zip-code. An additional two sites (Community Heath Resources/Free Clinics) were visited in the Midlands region with 13 people screened and 1 with detected HCV infection.
Fig. 3
Fig. 3
Diagram of use of the mobile health clinics. In addition to the patients who were screened by the clinics and were found to have an HCV infection, external organizations without the capacity to provide treatment referred HCV-infected patients to the mobile health clinics (N = 21), nine of whom were treated by the MHC program.
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References

    1. Stasi C., Silvestri C., Voller F. Update on hepatitis C epidemiology: unaware and untreated infected population could be the key to elimination. SN Compr Clin Med. 2020;2:2808–2815. doi: 10.1007/s42399-020-00588-3. - DOI - PMC - PubMed
    1. Havens P.L., Anderson J.R. Updated CDC recommendations for universal hepatitis C virus screening among adults and pregnant women: implications for clinical practice. JAMA. 2020;323:2258–2259. doi: 10.1001/jama.2020.3693. - DOI - PubMed
    1. McGowan C.E., Fried M.W. Barriers to hepatitis C treatment. Liver Int. 2012;32:151–156. doi: 10.1111/j.1478-3231.2011.02706.x. - DOI - PMC - PubMed
    1. Yu S.W.Y., Hill C., Ricks M.L., Bennet J., Oriol N.E. The scope and impact of mobile health clinics in the United States: a literature review. Int J Equity Health. 2017;16:178. doi: 10.1186/s12939-017-0671-2. - DOI - PMC - PubMed
    1. Malone N.C., Williams M.M., Smith Fawzi M.C., et al. Mobile health clinics in the United States. Int J Equity Health. 2020;19:40. doi: 10.1186/s12939-020-1135-7. - DOI - PMC - PubMed