Pretreatment Assessment of Psychosocial Readiness Is Not Associated with Improved Treatment Outcomes in a Safety-Net HCV Treatment Clinic

South Med J. 2020 Jun;113(6):261-266. doi: 10.14423/SMJ.0000000000001099.

Abstract

Objectives: Hepatitis C virus (HCV) is highly curable with antiviral therapy, and traditionally, treatment adherence has been critical for treatment success. We sought to determine whether assessing HCV treatment readiness with a structured treatment readiness tool was associated with increased rates of adherence and cure among patients at a safety-net HCV clinic.

Methods: We administered the Psychosocial Readiness Evaluation and Preparation for HCV Treatment (PREP-C) tool to 50 patients and compared them with 50 patients who received the usual care. The outcome measures included achievement of treatment milestones (eg, adherence to treatment, clinic visit attendance) and sustained virologic response (cure).

Results: We found no association between receiving the PREP-C assessment and outcomes, including referral to or starting HCV treatment, adherence to treatment, and HCV cure.

Conclusions: We found that receiving the PREP-C assessment did not improve treatment outcomes, suggesting that targeted pretreatment assessment is unnecessary even in a medically and psychosocially complex population.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alcohol Drinking / epidemiology
  • Antiviral Agents / therapeutic use*
  • Appointments and Schedules
  • Cognition*
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / psychology
  • Humans
  • Male
  • Medication Adherence*
  • Mental Disorders / epidemiology
  • Mental Health
  • Middle Aged
  • Motivation*
  • No-Show Patients
  • Safety-net Providers
  • Self Efficacy
  • Single-Blind Method
  • Social Support*
  • Substance-Related Disorders / epidemiology
  • Surveys and Questionnaires
  • Sustained Virologic Response*
  • Treatment Outcome

Substances

  • Antiviral Agents