New BMC primary care program for hepatitis C treatment shows promise

A patient-centered primary care model successfully treated 66 hepatitis C patients with oral medications, demonstrating a potential avenue for the expansion of HCV treatment, according to a new study published in the Annals of Family Medicine.

While HCV has been historically treated intravenously with interferon — a treatment associated with debilitating side effects — few studies have examined treatment models for HCV since the arrival of new oral medications, which have few side effects and are simple to prescribe.

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To evaluate the efficacy of a primary care model for the treatment of HCV, clinicians referred 302 Boston Medical Center patients to the program. Among the referrals, approximately 23 percent were able to receive treatment through the program. Many ineligible patients were deferred to specialists for several reasons: many had other health conditions, some were already engaged in treatment and others were ineligible for the program because of substance abuse issues.

The program involved a multi-disciplinary team consisting of a public health social worker, general internists, a pharmacy technician and a pharmacist.

"A multidisciplinary team was really the key to the program's success," said Karen Lasser, MD, founding medical director of the program, an internal medicine physician at BMC and a corresponding author of the study. "For example, the social worker played an integral role, guiding patients from referral through completion of treatment, and helping address several other social determinants of health that may have prevented these patients from getting treatment ... While our model employed general internists, family medicine physicians could implement a similar program."

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