Guiding Hepatitis C Patients Through Opioid Treatment Programs

An association was found between key characteristics of program managers and the rapid adoption of hepatitis C virus (HCV) testing services in opioid treatment programs (OTPs).

HCV affects about 3.2 million people in the United States, with 35% to 65% prevalence in at risk individuals, especially persons who inject drugs (PWID).

Although HCV testing is recommended for those who ever used or shared illicit injection drugs, implementing HCV testing into substance use disorder treatment programs (SUD) is incomplete.

In recent years, the implementation of HCV testing in SUD treatment programs has increased, but these treatment programs are continuing to refer clients to off-site facilities for testing.

This lack of integration remains a serious public health concern.

The current study collected data from the 2005 (n = 187) and 2011 (n = 196) National Drug Abuse Treatment System Survey (NDATSS), a survey that examines the organizational structures and operating characteristics of the nation’s outpatient SUD treatment programs.

Multivariate regression models were used to determine factors in the adoption of HCV testing. Covariates used in the study described program manager characteristics, which include: race and ethnicity, education, and their sources of information about developments in the field of SUD treatment.

Additionally, characteristics of OTPs and the client populations they serve were controlled.

The results of the study showed that there was a significant increase of OTPs that adopted HCV testing (73% in 2005 and 90% in 2011). However, on-site HCV testing among programs that offered testing had a statistically significant decline from 53% to 34%.

OTP program managers were predominantly white, with 75% in 2005 and 70% in 2011, and were also found to be mostly women.

Most of the program managers had a post-graduate education with 67.4% in 2005 and 74% in 2011.

Although OTP managers reported limited use of informational sources for field developments in SUD treatment, they expressed strong support for preventive services. Their preventive support score increased from 3.7 in 2005 to 4.0 in 2011 (p=0.004).

The manager’s support for preventive services in SUD treatment programs was found to be positively associated with the likelihood of offering any HCV testing services (aOR = 1.39, 95 % CI = 1.02 to 1.90).

Offering on-site HCV testing to OTP mangers was more common among African American managers (OR = 2.76, 95 % CI: 1.03 to 7.35), but older mangers were less likely to offer on-site HCV testing (aOR = 0.97, 95 % CI = 0.94 to 1.00).

On-site HCV testing was more commonly offered by program managers who used information sources about developments in SUD treatment (aOR = 2.35, 95 % CI = 1.39 to 3.97).

The characteristics of program managers were found to be an essential aspect of understanding the scope of available services for patients in OTPs and that manager characteristics are associated with the adoption of HCV.