Acceptability, Appropriateness, and Feasibility of An On-Site HCV “Test and Treat” Strategy at Opioid Treatment Programs in North America

Author: Oluwaseun Falade-Nwulia Sheree Schwartz Brittany Barnaba Danielle Signer Jennifer Price Ricardo Franco Jordan Feld Mark Sulkowski

Theme: Clinical Research Year: 2022

Background: The population level effectiveness of oral direct-acting antiviral therapies depends on their
reach. HCV treatment implementation strategies to improve adoption, implementation, and
maintenance of HCV treatment at opioid treatment programs (OTPs) have the potential to increase HCV
treatment uptake by people who use drugs (PWUD), advancing HCV elimination. Understanding
perceptions of the acceptability, feasibility and appropriateness of these approaches is critical to
support implementation
Methods: In preparation for the RAPID HCV study, a hybrid type 1 effectiveness-implementation
randomized controlled trial evaluating the impact of HCV treatment at OTPs with peer support to
increase HCV treatment uptake among PWUD, we assessed perceived pre-implementation feasibility,
acceptability, and appropriateness to sustain and scale up HCV treatment in OTPs. We surveyed clinical
leadership at five OTPs across Baltimore, Maryland, Birmingham, Alabama, San Francisco, California, and
Toronto, Canada. Implementation outcomes were measured from August 2021-May 2022 utilizing the
Acceptability of Intervention Measure (AIM), Intervention Appropriateness measure (IAM), and
Feasibility of Intervention measure (FIM) 4-item scales which are considered leading indicators of
implementation success.
Results: Clinical leaders at the OTP sites perceived that on-site HCV treatment was acceptable and
appropriate with high scores for acceptability to staff (average score, 5/5) and appropriately meeting
their OTP clients’ needs and priorities (4.9/5). OTP staff scored the feasibility of implementation slightly
lower, with an average score of 4.5/5. Potential barriers and concerns identified were: 1) Maintaining
the momentum of HCV treatment in the face of competing priorities; 2) Coordinating new tasks to
ensure smooth workflow integration and 3) Managing the politics and finances of a new on-site HCV
treatment program.
Conclusion: Successful implementation of HCV treatment by OTP providers requires attention to
contextual factors specific to the existing structure, finances, and workflow of the OTPs. Ongoing
measurement of implementation outcomes will be critical to understanding strategy effectiveness.
Disclosure of Interest: None

Download abstract Watch video