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March 14, 2026American Journal on Addictions0 citationsOpen Access

Improving access to direct acting antivirals via a multimodal integrated care program in an addiction medicine clinic

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AZArya ZandvakiliJRJoseph RattenniJBJames Burton

Key Points

  • This research aims to evaluate the impact of an integrated care program on HCV treatment initiation and completion in addiction medicine clinics.
  • Integrated care involved HCV screening and treatment in the addiction medicine clinic or via telemedicine with an infectious diseases specialist.
  • A retrospective chart review assessed the rates of direct acting antivirals initiation, completion, and sustained virological response.
  • The program's effects on DAA prescriptions and referrals to hepatology were also analyzed.
  • DAA initiation rates increased after the implementation of integrated care (HR 2.21, 95% CI 1.05–4.66).
  • There was a significant increase in DAA prescriptions from 0 to 0.6 per month (p = .004).
  • Referrals to hepatology decreased from 1 to 0.2 referrals per month (p = .001).
  • In-person prescribing of DAAs in the addiction medicine clinic was associated with higher rates of initiation (HR 42.46; 95% CI: 15.25–118.24) and completion (HR 8.33; 95% CI: 2.76–25.16).

Abstract

Abstract Background and Objectives Injection 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. Methods Integrated 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). Results Among 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 Conclusions An 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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Cite This Study

Zandvakili et al. (2026) studied this question.

synapsesocial.com/papers/69b4b9eb18185d8a3980216ahttps://doi.org/10.1111/ajad.70155
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