Changes In Quality Of Life Scores Before And After Hepatitis C Treatment By Inner-City Primary Teams In Inner-City Community Health Clinics

Author: Lai V, Hull M, Bacani N, Zhang W, Gallagher L, Elbaharia R, Nouch S

Theme: Epidemiology & Public Health Research Year: 2018

Background: Inner-city populations, including people who inject drugs (PWIDs), are often marginalized by substance use and mental health conditions, and carry the largest burden of Hepatitis C (HCV) infection, yet had low uptake of interferon-based therapies. The introduction of short duration and tolerable direct acting antiviral (DAA) regimens has shown to be effective in such populations, and has the potential to increase uptake; however, little is known about the effects of new HCV treatments in these groups beyond virologic response. Approach: This prospective cohort study evaluated participant reported Quality of Life (QoL) scores using the Eq5D3L at HCV treatment initiation and at end of treatment. Treatment was delivered by interdisciplinary teams within three Vancouver inner-city primary care clinics between September 2015 and October 2017. Participants also completed questionnaires related to their demographics, substance use, and attendance to medical care. Changes in QoL scores, baseline and on-treatment factors were analyzed using the Bowker’s Test of symmetry. Outcome: Overall, there was no significant change in QoL scores from beginning to end of HCVtreatment (baseline median score 7.0; end of treatment median score of 7.5 (p=0.094)). However, participants who attended an optional HCV support group most frequently, defined as every week or more, experienced significant improvements in the “usual activities” (p=0.020) and in the “global scores” (p=0.006) categories of the EQ5D3L questionnaire compared to patients who did not attend group as frequently. Self-reported IVDU during the month before treatment or during treatment did not have a statistically significant effect on the quality of life scores. Conclusion: Frequent HCV group attendance for participants receiving HCV treatment was associated with improvement in QoL scores within a complex inner-city Vancouver population. Frequent group attendance may represent more social connectedness, increased engagement in care and may provide a support network for patients. Disclosure of interest statement: Valerie Lai does not have any disclosures.

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