A randomized trial of a hepatitis care coordination model in methadone maintenance treatment.
OBJECTIVE
We evaluated the efficacy of a hepatitis care coordination intervention to improve linkage to hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccination and clinical evaluation of hepatitis C virus (HCV) infection among methadone maintenance patients.


METHODS
We conducted a randomized controlled trial of 489 participants from methadone maintenance treatment programs in San Francisco, California, and New York City from February 2008 through June 2011. We randomized participants to a control arm (n = 245) and an intervention arm (n = 244), which included on-site screening, motivational-enhanced education and counseling, on-site vaccination, and case management services.


RESULTS
Compared with the control group, intervention group participants were significantly more likely (odds ratio [OR] = 41.8; 95% confidence interval [CI] = 19.4, 90.0) to receive their first vaccine dose within 30 days and to receive an HCV evaluation within 6 months (OR = 4.10; 95% CI = 2.35, 7.17). A combined intervention adherence outcome that measured adherence to HAV-HBV vaccination, HCV evaluation, or both strongly favored the intervention group (OR = 8.70; 95% CI = 5.56, 13.61).


CONCLUSIONS
Hepatitis care coordination was efficacious in increasing adherence to HAV-HBV vaccination and HCV clinical evaluation among methadone patients.
Carmen L. Masson, Kevin L. Delucchi, Jennifer Hettema, Nicole Pepper, Jessica Hall, Nicholas S. Hengl, Michael S. Shopshire, Jennifer K. Manuel, Bradley Shapiro, and James L. Sorensen are with the Department of Psychiatry, Mandana Khalili is with the Department of Medicine, and Hali Hammer is with the Department of Family and Community Medicine, University of California, San Francisco. Courtney McKnight, Albert Min, Ashly E. Jordan, Christopher Young, Lara Coffin, Randy M. Seewald, Henry C. Bodenheimer, Jr, Don C. Des Jarlais, and David C. Perlman are with the Beth Israel Medical Center, New York, NY.
Carmen L
CL
Masson
Kevin L
KL
Delucchi
Courtney
C
McKnight
Jennifer
J
Hettema
Mandana
M
Khalili
Albert
A
Min
Ashly E
AE
Jordan
Nicole
N
Pepper
Jessica
J
Hall
Nicholas S
NS
Hengl
Christopher
C
Young
Michael S
MS
Shopshire
Jennifer K
JK
Manuel
Lara
L
Coffin
Hali
H
Hammer
Bradley
B
Shapiro
Randy M
RM
Seewald
Henry C
HC
Bodenheimer
James L
JL
Sorensen
Don C
DC
Des Jarlais
David C
DC
Perlman
D000328:Adult; D016001:Confidence Intervals; D005260:Female; D006506:Hepatitis A / Q000517:prevention & control*; D006509:Hepatitis B / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009519:New York City; D058850:Opiate Substitution Treatment; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance / Q000706:statistics & numerical data; D012495:San Francisco; D014611:Vaccination
D008691:Methadone