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Risk Factors Associated With Unsuccessful Linkage to Outpatient Hepatitis C Care
Carlo Foppiano Palacios1,2, Brianna Dubose3, Sarah Schmalzle4
1Department of Medicine, Cooper University Hospital, Camden, USA.
Cureus
|May 16, 2024
Summary
Many patients miss appointments for hepatitis C virus (HCV) treatment due to social determinants of health like transportation issues. Addressing these barriers is crucial for successful HCV care linkage and treatment completion.
Area of Science:
- Hepatology
- Infectious Diseases
- Public Health
Background:
- Direct-acting antivirals (DAAs) offer curative treatment for hepatitis C virus (HCV).
- Population-level HCV treatment can reduce chronic infection prevalence.
- Many patients do not complete the HCV treatment cascade, hindering public health goals.
Purpose of the Study:
- To evaluate factors limiting linkage to outpatient HCV care.
- To identify social determinants of health (SDHs) associated with missed HCV appointments.
Main Methods:
- A case-control study matched patients who missed and attended HCV appointments in 2018 using propensity scores (1:1 ratio).
- Bivariate and multivariate analyses identified factors associated with missed appointments.
Main Results:
- 10.5% of 1,539 patients missed their HCV clinic appointment.
- Transportation difficulty and inpatient screening were significantly associated with missed appointments (multivariate analysis).
- Factors like housing instability and medication non-adherence were also linked to missed visits.
Conclusions:
- Patients missing initial HCV infectious disease (ID) clinic appointments face barriers including housing instability and transportation difficulties.
- Additional support is needed to address SDHs and improve linkage to outpatient HCV care.
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