Oregon gets $7.5M US grant to treat HCV with telehealth, peer support
Model expands to 20 rural areas to improve care for recreational drug users
A three-year program in Oregon is receiving a $7.5-million federal grant to improve healthcare for rural residents who use recreational drugs. The program will use telehealth and peer support — connecting patients with peers who have navigated the system themselves — to ensure these residents can get tested and treated for conditions like hepatitis C.
“Over the next three years, we’re going to change the way rural people who use drugs access health care,” Hunter Spencer, an associate professor of medicine at Oregon Health and Science University (OHSU), said in a university news story. “Treating hepatitis C is a step on the path of improving overall health.”
The hepatitis C virus (HCV) is spread by contact with bodily fluids and infects the liver, causing inflammation that can set the stage for life-threatening complications like cancer or liver failure. In the U.S., HCV is most commonly spread through contaminated equipment used to administer drugs.
Barriers to care
Antiviral therapies for HCV are available and can cure the infection in nearly all cases. However, many people infected with the virus aren’t able to access treatment due to factors like stigma and logistics. This is especially true for drug users in rural areas.
Telehealth involves having patients meet with doctors over the phone or via video call, rather than in person. In recent years, particularly since quarantines mandated by the COVID-19 pandemic, there has been increasing interest in the use of telehealth to make it easier for people to access healthcare.
The new funding, which comes from the Substance Abuse and Mental Health Services Administration within the U.S. Department of Health and Human Services, will expand on findings from an OHSU-sponsored clinical trial called TeleHepC (NCT04798521).
In that trial, hundreds of people in rural Oregon who had a recent history of recreational drug use and chronic, untreated hepatitis C were either referred to an in-person medical appointment or met with a doctor via telehealth. Those given telehealth were also connected with peers in the community who have first-hand experience navigating the healthcare system as a drug user.
Results from that trial, published last year, showed participants who received telehealth support were seven times more likely to start treatment than those referred for in-person care.
Also, most participants who received telehealth support (63%) were cured of HCV within six months, compared with 16% of those receiving usual, in-person care, reflecting a four times higher chance of virus clearance with the telehealth support.
“The Oregon model of community, state and academic partnerships re-imagines health care delivery for Oregonians who need it most,” said Todd Korthuis, MD, head of addiction medicine at OHSU. “Peers in the community make it easier for people to engage directly in life-saving care. That makes all of our communities stronger.”
The new funding will expand the telehealth project so it’s available in 20 of Oregon’s 36 counties, with same-day hepatitis C testing and treatment available in six days.
The project will also offer resources for the treatment and prevention of other conditions associated with substance use, including HIV and opioid use disorder, as well as mental health support and treatment.
“With the peer support, we can see that people gain experience navigating a health care system, and they gain confidence and an interest in making other health-related changes,” Spencer said. “We see that it helps people move forward in making other changes in their lives.”
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