07/25/2018 – Bethesda, MD – The Medical Technology and Practice Patterns Institute (MTPPI) has announced that the results from its most recent research collaboration with the Alameda Health System, University of Texas Southwestern Medical Center, Ochsner Health System, and Bon Secours Health System have been published in the journal Hepatology, the official journal of the American Association for the Study of Liver Diseases (AASLD). The multi-site project investigated the research question “Has access to Hepatitis C (HCV) therapy changed for patients with mental health or substance use disorders in the direct-acting antivirals (DAA) period?”
To answer this question, investigators conducted a retrospective analysis of 29,544 adults with chronic HCV who did or did not receive treatment. The examined medical records covered the pre-DAA (1/1/11-12/31/13) and post-DAA (1/1/14-2/28/17) periods. The project’s data analysis team used Kaplan-Meier curves to examine cumulative risk for receiving HCV treatment stratified by mental health or substance use disorders (MH/SUD). Predictors of HCV treatment in the pre-DAA and post-DAA cohorts were analyzed using multivariate generalized estimating equations (GEE) and modified Poisson models.
The study team found that overall, 21.7% of those with chronic HCV post-DAA were treated compared to 3.5% in the pre-DAA period. Compared to non-Hispanic Whites, Hispanic Whites were less likely to be treated in the post-DAA period and those with concurrent nonalcoholic fatty liver disease, cirrhosis, and receiving a liver transplant were more likely to be treated post-DAA. Those with MH/SUD were less likely to be treated both before and after DAA therapy was available.
“This real-world study shows that in the post-DAA period only 1 in 5 of those with chronic Hepatitis C was being treated for the disease in the four large healthcare settings across the US that collaborated on this project.”, said Dr. Mae Thamer, MTPPI’s Director of Research. “Patients with mental health and substance use disorders are especially at risk of not receiving the proper treatment for HCV and have a significantly lower likelihood of obtaining access to treatment.”
The project team is currently working on the second phase of this investigation which will focus on analyzing research questions related to the treatment of Hepatitis B.
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