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Facilitated telemedicine for hepatitis C virus: Addressing challenges for improving health and life for people with opioid use disorder

BACKGROUND: People who use drugs (PWUD) frequently delay or avoid obtaining medical care in traditional healthcare settings. Through a randomized controlled trial, we investigated facilitated telemedicine for hepatitis C virus (HCV) integrated into opioid treatment programmes. We sought to understan...

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Autores principales: Talal, Andrew H., Jaanimägi, Urmo, Dharia, Arpan, Dickerson, Suzanne S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10632612/
https://www.ncbi.nlm.nih.gov/pubmed/37641398
http://dx.doi.org/10.1111/hex.13854
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author Talal, Andrew H.
Jaanimägi, Urmo
Dharia, Arpan
Dickerson, Suzanne S.
author_facet Talal, Andrew H.
Jaanimägi, Urmo
Dharia, Arpan
Dickerson, Suzanne S.
author_sort Talal, Andrew H.
collection PubMed
description BACKGROUND: People who use drugs (PWUD) frequently delay or avoid obtaining medical care in traditional healthcare settings. Through a randomized controlled trial, we investigated facilitated telemedicine for hepatitis C virus (HCV) integrated into opioid treatment programmes. We sought to understand the experiences and meanings of facilitated telemedicine and an HCV cure among PWUD. METHODS: We utilized purposive sampling to interview 25 participants, 6–40 months after achieving an HCV cure. We interpreted and explicated common meanings of participants' experiences of an HCV cure obtained through facilitated telemedicine. RESULTS: Participants embraced facilitated telemedicine integrated into opioid treatment programmes as patient‐centred care delivered in ‘safe spaces’ (Theme 1). Participants elucidated their experiences of substance use and HCV while committing to treatment for both entities. Facilitated telemedicine integrated into opioid treatment programmes enabled participants to avoid stigma encountered in conventional healthcare settings (Theme 2). Participants conveyed facing negative perceptions of HCV and substance use disorder. Improved self‐awareness, acquired through HCV and substance use treatment, enabled participants to develop strategies to address shame and stigma (Theme 3). An HCV cure, considered by PWUD as a victory over a lethal infectious disease, promotes self‐confidence, enabling participants to improve their health and lives (Theme 4). CONCLUSIONS: Integrating facilitated telemedicine into opioid treatment programmes addresses several healthcare barriers for PWUD. Similarly, obtaining an HCV cure increases their self‐confidence, permissive to positive lifestyle changes and mitigating the negative consequences of substance use. PATIENT AND PUBLIC CONTRIBUTION: In this study of patient involvement, we interviewed patient‐participants to understand the meaning of an HCV cure through facilitated telemedicine. Participants from a facilitated telemedicine pilot study provided essential input on the design and outcomes of a randomized controlled trial. Pilot study participants endorsed facilitated telemedicine in a testimonial video. They attended site initiation meetings to guide trial implementation. A Patient Advisory Committee (PAC) ensured that patient participants were active members of the research team. The PAC represented patients' voices through feedback on study procedures. A Sustainability Committee supported public involvement in the research process, including educational opportunities, feedback on implementation, and future sustainability considerations.
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spelling pubmed-106326122023-11-15 Facilitated telemedicine for hepatitis C virus: Addressing challenges for improving health and life for people with opioid use disorder Talal, Andrew H. Jaanimägi, Urmo Dharia, Arpan Dickerson, Suzanne S. Health Expect Original Articles BACKGROUND: People who use drugs (PWUD) frequently delay or avoid obtaining medical care in traditional healthcare settings. Through a randomized controlled trial, we investigated facilitated telemedicine for hepatitis C virus (HCV) integrated into opioid treatment programmes. We sought to understand the experiences and meanings of facilitated telemedicine and an HCV cure among PWUD. METHODS: We utilized purposive sampling to interview 25 participants, 6–40 months after achieving an HCV cure. We interpreted and explicated common meanings of participants' experiences of an HCV cure obtained through facilitated telemedicine. RESULTS: Participants embraced facilitated telemedicine integrated into opioid treatment programmes as patient‐centred care delivered in ‘safe spaces’ (Theme 1). Participants elucidated their experiences of substance use and HCV while committing to treatment for both entities. Facilitated telemedicine integrated into opioid treatment programmes enabled participants to avoid stigma encountered in conventional healthcare settings (Theme 2). Participants conveyed facing negative perceptions of HCV and substance use disorder. Improved self‐awareness, acquired through HCV and substance use treatment, enabled participants to develop strategies to address shame and stigma (Theme 3). An HCV cure, considered by PWUD as a victory over a lethal infectious disease, promotes self‐confidence, enabling participants to improve their health and lives (Theme 4). CONCLUSIONS: Integrating facilitated telemedicine into opioid treatment programmes addresses several healthcare barriers for PWUD. Similarly, obtaining an HCV cure increases their self‐confidence, permissive to positive lifestyle changes and mitigating the negative consequences of substance use. PATIENT AND PUBLIC CONTRIBUTION: In this study of patient involvement, we interviewed patient‐participants to understand the meaning of an HCV cure through facilitated telemedicine. Participants from a facilitated telemedicine pilot study provided essential input on the design and outcomes of a randomized controlled trial. Pilot study participants endorsed facilitated telemedicine in a testimonial video. They attended site initiation meetings to guide trial implementation. A Patient Advisory Committee (PAC) ensured that patient participants were active members of the research team. The PAC represented patients' voices through feedback on study procedures. A Sustainability Committee supported public involvement in the research process, including educational opportunities, feedback on implementation, and future sustainability considerations. John Wiley and Sons Inc. 2023-08-28 /pmc/articles/PMC10632612/ /pubmed/37641398 http://dx.doi.org/10.1111/hex.13854 Text en © 2023 The Authors. Health Expectations published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Talal, Andrew H.
Jaanimägi, Urmo
Dharia, Arpan
Dickerson, Suzanne S.
Facilitated telemedicine for hepatitis C virus: Addressing challenges for improving health and life for people with opioid use disorder
title Facilitated telemedicine for hepatitis C virus: Addressing challenges for improving health and life for people with opioid use disorder
title_full Facilitated telemedicine for hepatitis C virus: Addressing challenges for improving health and life for people with opioid use disorder
title_fullStr Facilitated telemedicine for hepatitis C virus: Addressing challenges for improving health and life for people with opioid use disorder
title_full_unstemmed Facilitated telemedicine for hepatitis C virus: Addressing challenges for improving health and life for people with opioid use disorder
title_short Facilitated telemedicine for hepatitis C virus: Addressing challenges for improving health and life for people with opioid use disorder
title_sort facilitated telemedicine for hepatitis c virus: addressing challenges for improving health and life for people with opioid use disorder
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10632612/
https://www.ncbi.nlm.nih.gov/pubmed/37641398
http://dx.doi.org/10.1111/hex.13854
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