Grosgebauer Kaitlin, Bartholomew Tyler S, Huynh Katherine, Cos Travis
Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Miami, FL, 33136, USA.
National Nurse-Led Care Consortium, Philadelphia, PA, USA.
J Prim Prev. 2021 Apr;42(2):203-215. doi: 10.1007/s10935-021-00627-2. Epub 2021 Mar 18.
Hepatitis C virus (HCV) infection is a public health issue that claims the lives of 350,000 individuals globally every year. Primary care providers are increasingly prescribing HCV medications with more modern, simplified administrations. Individuals with HCV are disproportionately affected by behavioral health challenges and substance use disorders. Integrated behavioral health providers can work in concert with their patients' primary care teams to provide innovative treatment programs to help support the needs of HCV care. We used simple and multivariable logistic regression to determine the association between receipt of behavioral health consultation and two outcomes on the care continuum: insurance approval for treatment and initiated HCV treatment regimen. These models were fitted using theoretically hypothesized variables and multivariable regression models included age, sex, and race/ethnicity as potential confounders. From January 2015 to May 2017, 189 patients at health centers were referred for onsite HCV primary care treatment. Of these, 142 were approved for participation, and 132 started treatment. Simple regression revealed a significant association between behavioral health consultation and treatment approval; however, behavioral health consultation was non-significant in the multivariable model for treatment approval. For initiating HCV treatment, onsite behavioral health consultation was significantly associated in both the unadjusted and adjusted regression models. Integrating behavioral health services for patients seeking HCV treatment may improve movement across the care continuum, optimizing patient's HCV health outcomes. Behavioral health consultation in primary care settings should be studied further to improve HCV treatment outcomes for patients with behavioral health and substance use disorders.
丙型肝炎病毒(HCV)感染是一个公共卫生问题,每年在全球导致35万人死亡。初级保健提供者越来越多地开出处方,使用更现代、更简化给药方式的丙肝药物。丙肝患者在行为健康挑战和物质使用障碍方面受到的影响尤为严重。综合行为健康服务提供者可以与患者的初级保健团队协同工作,提供创新的治疗方案,以帮助满足丙肝护理的需求。我们使用简单和多变量逻辑回归来确定接受行为健康咨询与护理连续过程中的两个结果之间的关联:治疗的保险批准和启动丙肝治疗方案。这些模型使用理论假设变量进行拟合,多变量回归模型将年龄、性别和种族/族裔作为潜在混杂因素。从2015年1月到2017年5月,健康中心的189名患者被转诊接受现场丙肝初级保健治疗。其中,142人被批准参与,132人开始治疗。简单回归显示行为健康咨询与治疗批准之间存在显著关联;然而行为健康咨询在治疗批准的多变量模型中不显著。对于启动丙肝治疗,现场行为健康咨询在未调整和调整后的回归模型中均显著相关。为寻求丙肝治疗的患者整合行为健康服务可能会改善护理连续过程中的进展情况,优化患者的丙肝健康结果。应进一步研究初级保健环境中的行为健康咨询,以改善患有行为健康和物质使用障碍患者丙肝的治疗结果。