P4626 - An Academic Institution’s Early Lessons in Linking Care to Socioeconomically Disadvantaged Hepatitis C Patients

Tara Kronen, DO, MA¹, Gregory Churchill, DO¹, Landen Shane Burstiner, MSc, DO², Oshin Rai, DO¹, Gerardo Diaz Garcia, DO¹, Anvit Reddy, DO¹, Vaibhav Rastogi, MD¹, Brandi Wells, MPH,CCRC¹, Alexis Goodman, ¹, Maged A.. Ghali, MD^1
1University of Florida College of Medicine, Jacksonville, FL; ²University of Florida Health, Jacksonville, FL

Introduction: In 2016, the World Health Assembly (WHA) endorsed the elimination of viral hepatitis by 2030. Despite this initiative, the Americas faced a significant challenge in 2022, with an estimated 5.3 million people living with Hepatitis C Virus (HCV) and a treatment rate of only 26.0%. Investigators must assess the effectiveness of various recruitment efforts to link HCV patients with definitive care, especially in low socioeconomic communities where social determinants of health negatively influence linkage.

Methods: The University of Florida (UF) Jacksonville Hepatology Department received a grant from the Center for Disease Analysis Foundation (CDAF) to link untreated HCV patients to care. Patients in the UF Jacksonville health system were identified through EPIC by filtering for HCV antibody positivity with a recent positive viral load or absence of a viral load test. Additional filtering included patients with prior hepatology clinic visits or referrals. This enabled the project to maintain a Quality Improvement (QI) designation for greater latitude in contacting patients. The Office of Research Affairs at UF contacted patients by telephone or email using EPIC demographic data, arranging appointments directly with hepatology clinic fellows for treatment evaluation.

Results: 495 patients screened into the study with the following demographics: 43.6% female, 56.4% male, mean age 60 years, 52.3% Caucasian, and 43.6% Black. All of the patients were telephoned at least once between March and June 2024 resulting in 30.3% contacted, 12.3% willing to discuss treatment, 5.0% directly scheduled, and 1.2% successfully linked (76% no show rate). For those unreachable by telephone, 185 patients (37.4%) were emailed yielding only 1 response with 0% linkage.

Discussion: Linkage to care through telephone or email was grossly unsuccessful in this urban, low socioeconomic community. There was a steep drop in participation along each chain link: patient identification, initial contact, willingness to schedule, and appointment attendance. The frequency of changing telephone numbers was likely a significant barrier as most patients were unreachable. Additionally, a lack of education surrounding HCV and its health implications likely contributed to a reluctance to be seen. Moreover, we suspect unreliable transportation contributed to missed appointments. These factors all link to the need to address social determinants of health in our community for the successful eradication of HCV.


Disclosures:


Tara Kronen, DO, MA¹, Gregory Churchill, DO¹, Landen Shane Burstiner, MSc, DO², Oshin Rai, DO¹, Gerardo Diaz Garcia, DO¹, Anvit Reddy, DO¹, Vaibhav Rastogi, MD¹, Brandi Wells, MPH,CCRC¹, Alexis Goodman, ¹, Maged A.. Ghali, MD¹. P4626 - An Academic Institution’s Early Lessons in Linking Care to Socioeconomically Disadvantaged Hepatitis C Patients, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.