Boston Medical Center eliminated the hepatitis C virus (HCV) in 66 patients it treated with a comprehensive care program that included doctors, pharmacists, pharmacy techs and social workers, according to a study.
The doctors were general practitioners, so a key conclusion of the research was that primary care providers could deliver HCV treatment as well as specialists.
The center’s Adult Primary Care Practice used what it called the patient-centered medical home model of care to treat the patients between March 2015 and April of 2016. The word “home” does not refer to receiving care at home. It invokes a care home that patients can find comfort in.
The Agency for Healthcare Research and Quality said the medical home model includes five key elements: comprehensive care, patient-centered care, coordinated care, accessible services, and quality and safety.
With new HCV treatments becoming standard, studies have suggested that care providers ought to be delivering them to underserved areas, such as minority communities. Traditionally, doctors used interferon injections to treat HCV. But new oral regimens are easier to administer, more effective and generate fewer side effects.
Boston Medical Center researchers decided to see how well an oral regimen would work under a comprehensive medical home care model. Sixty-six of the 302 patients that doctors referred for the treatment ended up taking it.
The medical home team included primary care physicians trained to treat HCV, a pharmacist, a public health social worker, and a pharmacy tech.
Patients met with their primary care physician three times and their pharmacist once during the treatment. The doctors and pharmacist discussed their medication, the importance of sticking with treatment, and possible side effects of the therapy.
The social worker’s responsibilities were similar to those of the patient navigators who provide crucial support to patients during therapy. The social workers reminded patients about appointments and helped them with transportation and insurance issues. They also talked with patients about their income and housing challenges, and behavioral, emotional and social needs.
“A multidisciplinary team was really the key to the program’s success,” Dr. Karen Lasser, the founding medical director of the program, said in a press release. “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.”
Lasser, an internal medicine physician at the center, was the corresponding author of a study on the medical home model that was published recently in the journal Annals of Family Medicine. It was titled “A Hepatitis C Treatment Program Based in a Safety-Net Hospital Patient-Centered Medical Home.”
The study confirmed that primary care physicians can deliver HCV treatment effectively.
“This primary care HCV treatment program shows real promise through its impressive outcomes for curing selected patients of HCV,” Lasser said. “While our model employed general internists, family medicine physicians could implement a similar program.”