Public health experts have long advocated for approaches to health care that meet people where they’re at. Now, a group of New England researchers and medical professionals are exploring how this approach might help reduce rates of Hepatitis C among rural residents who use intravenous drugs.
For the past few months, Baystate Health, Tufts University School of Medicine and the Hanover-based healthcare startup Better Life Partners have been running a mobile health van offering medical care and blood testing at syringe-exchange sites along the Connecticut River Valley.
If someone tests positive for Hepatitis C at one of the sites, they will be randomly steered toward one of two paths for follow-up care. Half will be offered a telehealth appointment from the van and quick access to treatment. The other half will be referred out to the more traditional healthcare system to schedule their own appointment.
Researchers aim to enroll about 220 participants and compare how each group of patients stick with their treatment plans. Depending on funding, they hope to track patients for several years and also look at rates of reinfection. While reinfection is possible, other studies have shown its rates are low.
While the hypothesis is that the group receiving telehealth care will have better health outcomes, Dr. David de Gijsel, one of the physicians working on the research, sees the trial as “the same as running a controlled trial for a new drug.”
In that case, “the hypothesis (supported by preliminary data) is that treatment is better than placebo, but only a randomized trial can prove that,” said de Gijsel, who also serves as Better Life Partners’ Chief Health Officer.
If his hypothesis holds, he hopes it will help to convince policymakers and “health care providers that providing telemedicine and not requiring people to come to the office is a safe and effective way” to provide care.
Researchers have estimated that over 50% percent of people in the U.S. who inject drugs have a Hepatitis C infection. That’s compared to 1% among the general population, according to estimates from the CDC.
De Gijsel said an initial study conducted by Baystate and Tufts found similar rates of Hepatitis C among people who inject drugs in several rural counties in western Massachusetts, Vermont and New Hampshire.
“People who struggle with addiction often times have had very, very bad experiences, very stigmatizing experiences in our health care system,” he said. “And therefore, it's hard for folks to establish care to seek Hepatitis C treatment.”
