Methadone Maintenance Patients’ Knowledge, Attitudes, Beliefs, and Experiences Concerning Treatment for Hepatitis C Virus Infection

Abstract

Hepatitis C virus (HCV) knowledge, attitudes, beliefs, and experiences (KABE) of 64 HCV antibody positive methadone maintenance treatment (MMT) patients were assessed in conjunction with acceptability of an on-site semi-structured HCV education session, HCV RNA diagnostic testing, HCV treatment motivational assessment, and initiation of HCV treatment. The KABE interviews were conducted in 2006 and 2007 in an urban New York State MMT clinic in affiliation with a NIDA-funded HCV research project. The majority had basic knowledge of HCV disease, but poor understanding of HCV testing and treatment. While the majority of participants expressed fear of HCV treatment side effects, 88%% accepted HCV RNA testing and 78%% expressed willingness to start HCV treatment with the majority of chronically infected choosing to start HCV treatment medications. Study limitations and implications are discussed.

RÉSUMÉ

Les connaissances, attitudes, croyances, et expériences des patients au traitment d’entretien a la méthadone concernant le traitement de l’infection de virus de l’hépatite C (VHC)

Les connaissances, attitudes, croyances, et experiences (CACE) de 64 patients positifs pour l’anticorps du virus de l’hépatite C (VHC) et sous traitement d’entretien à la méthadone ont été évaluées en conjonction avec l’acceptabilité d’une session educative de semi-structurée sur VHC, les tests diagnostique d’ARN du VHC, l’évaluation de la motivation au traitment du VHC et son initiation. Les interviews de CACE furent menées en 2006 et 2007 dans une clinique de traitement d’entretien de méthadone d’un centre urbain de l’état de New-York en affiliation avec un projet de recherche du VHC financé par NIDA (Institut National de la Toxicomanie). La plupart avait une connaissance de base de la maladie du VHC, mais une mauvaise comprehension du depistage et du traitment du VHC, 88%% ont accepté le despitage d’ARN du VHC et 78%% ont exprimé la volonté de commencer les médicaments de traitement de VHC dont la majorité sont chroniquement infecté. Des limitations et implications de l’étude sont discutées.

RESUMEN

El conocimiento, actitud, creencia, y experiencia del virus de hapatitis C en pacientes en el mantenimiento de metadona concerniendo el tratamiento del virus de hepatitis C

El conocimiento, actitud, creencia, y experiencia de el paciente en el mantenimiento de metadona y con el anticuerpo sesenta cuatro del virus de hepatitis C positivo fueron valorados en conjunción con con aceptabilidad de una sesión medida estructurada local de la educación de HCV, de RNA de HCV probar diagnóstico, de tratamiento de HCV evaluación motivadora, y de la iniciación de tratamiento de HCV. Las entrevistas sucedieron entre 2006 y 2007 en clinica situado en Nueva York urbana. La mayoría tuvo el conocimiento básico de la enfermedad de HCV, pero pobre comprensión en la manera de probar y en el tratamiento de HCV. La mayoría de participantes expresó temor del tratamiento y los efectos secundarios, 88%% aceptaron probar del RNA de HCV y 78%% expresaron comenzar tratamiento con la mayoría siendo los pacientes infectado crónicamente. Las limitaciones del estudio e implicaciones son discutidas.

Keywords :

• hepatitis C
• treatment
• knowledge
• attitudes
• beliefs
• experiences
• methadone
• opioid
• substance use
• psychiatry

THE AUTHORS

Kelly M. Canfield, MSN, FNPC, is a research project manager, clinical instructor, and nurse practitioner in the Department of Psychiatry at Upstate Medical University in Syracuse, New York. Ms. Canfield is currently in her second year of post-master's education in the Upstate Medical University's Family Psychiatric Nurse Practitioner program. She is involved in addiction research, which focuses on co-occurring psychiatric and medical disorders including opioid addiction and hepatitis C virus infection, as well as nicotine and alcohol dependence in severe mental illness. Ms. Canfield has written, taught, and presented extensively on co-occurring disorders research.

Steven L. Batki, MD, is Adjunct Professor of Psychiatry at the University of California, San Francisco (UCSF) School of Medicine and Director of the Addiction Psychiatry Research Program at the San Francisco VA Medical Center. Dr. Batki is engaged in addiction research, training, and clinical services. His research focuses on the pharmacological treatment of addiction and co-occurring psychiatric and medical disorders. He chaired the SAMSHA CSAT Treatment Improvement Protocol No. 37, Substance Abuse Treatment for Persons with HIV/AIDS, and Treatment Improvement Protocol No. 43, Medication-Assisted Treatment for Opioid Dependence. Dr. Batki has recently completed the NIDA-funded study, “Improving Hepatitis C Treatment in Injection Drug users”—a randomized trial of hepatitis C medical treatment delivered in a methadone treatment setting versus in a GI/hepatology clinic.

Emily Smyth, BS, has a Bachelor's of Science degree in Psychology and is currently attending the State University of New York at Stony Brook in the Physician Assistant Master's Degree Program. Ms. Smyth was a research assistant in the Department of Psychiatry at SUNY Upstate Medical University at the time of formulation of this paper. She assisted with subject recruitment, data collection, and data analysis.