The prevalence of hepatitis C virus (HCV) infection among VA patients
is 3 times higher than in the general population. Recent VA data
indicate that only about 14% of all HCV-infected VA patients have ever
received antiviral therapy. Barriers to receiving antiviral treatment
include factors such as pre-existing psychiatric illness, ongoing
substance abuse, and other medical co-morbidity. Using a new
protocol-based model of care that centers around integrating psychiatric
care and case management into VA HCV clinics may increase treatment
rates, improve rates of sustained viral response (SVR), and improve
health outcomes for veterans with hepatitis
The HCV study aims to determine the effectiveness of this
protocol-based integrated care model for increasing treatment rates and
the number of patients who receive successful antiviral treatment. The
study will also assess the effects of an integrated care model on
patient involvement in care.
The HCV study uses a prospective patient level randomized design to
examine the effectiveness of this intervention at 3 major VA medical
centers. All clinic patients who screen positive on 1 or more measures
of depression, anxiety, PTSD, or recent SUDs are asked to participate.
These questionnaire data, which are processed, stored, and maintained at
HSRC, have the potential to significantly impact patient care and
future healthcare decisions. Preliminary data suggest that 85% of HCV
clinic patients screen positive on at least one measure.
Eligible patients are randomized to either usual or integrated care
at each site. The integrated care intervention follows a standardized
protocol consisting of a series of brief interventions tailored to each
patient’s main barriers to treatment. In addition, it employs a case
management approach in which the integrated care mental health provider
actively tracks each patient’s progress through the evaluation and
treatment process. The integrated care mental health providers—clinical
nurse specialists, psychologists, or licensed clinical social
workers—all have experience and training in the provision of psychiatric
and SUD interventions and also receive additional training on the
integrated care protocol.
For more information visit http://www.hsrd.research.va.gov/research/abstracts.cfm?Project_ID=2141698874 or contact Eliza Robillos at firstname.lastname@example.org.