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Anthony Martinez, MD: It sounds like there are three levels of barriers – patients, providers and the system itself that can be difficult to navigate, right?A term we often hear is task transfer. This concept can help us overcome some of these obstacles. Jordan, can you define that? What does this mean? How do you see the importance of that in… closing some of these gaps?
Jordan Mayberry, PA-C: Absolutely. We know that APPs (Advanced Practice Providers), our Nurse Practitioners and PAs (Physician Assistants) are important members of the health care system. And…about 75% of HCV (hepatitis C virus) patients are now being managed through APPs. So I think it’s really important that we educate our APP colleagues about this disease state, about these great and easy-to-use drugs, so that we can continue to screen and treat these patients with the help of our APP colleagues.
Anthony Martinez, MD: So they’re actually an important part of achieving elimination. I mean, this is where the majority of patients are screened, where they’re diagnosed, where they’re actually treated, so we really need the support of our APP colleagues to be able to… get this done. Tipu, do you think task shifting in the addiction medicine community has a similar effect?
Tipu V. Khan, MD: fork. This makes me very excited. I like this topic. As we discussed with Mark in the data, young drug-using patients who inject drugs do drive hepatitis C rates. Again, these patients are healthy. They won’t go elsewhere for health care, but where will they go? They went to a methadone clinic. They go to MAT (medication-assisted treatment) providers, primary care physicians to get medications for opioid use disorder…so when we see them there, it’s great for us to screen and treat chance them. In my opinion, I do think addiction medications are at the forefront of hepatitis C treatment. As a fellowship director, I train all…my colleagues (to recognize) that when you treat patients for any substance use disorder, you need to update the screening guidelines, but you need to feel comfortable with the management because of these Patients may not see their primary care physician. They may not see a gastroenterologist, hepatologist, or infectious disease specialist. They may just come to you to get a buprenorphine prescription or other MOUD (medication to treat opioid use disorder)…so when you (have) them, you have to feel comfortable treating (them). I do think that co-localizing treatments for hepatitis C with addictive drugs under the same roof is very important in eradicating hepatitis C.
Anthony Martinez, MD: Tipu, I’m going to pose this question to you and Jordan. Do you think hepatitis C is a gateway to dealing with some of the other comorbidities, whether it’s addiction drugs or addiction comorbidities, or if they have some primary care comorbidities, do you both think hepatitis C) ) C might lead to handling Some of these other questions?
Tipu V. Khan, MD: Actually, I think it’s a two-way street…it goes both ways. In my practice, we have a lot of patients who come in for MOUD…and then we screen them and we find out they have hepatitis C, which opens the door to treating their hepatitis C, but also establishing some basic Primary care. The opposite is certainly true. In our primary care clinic, many patients (red) who are diagnosed with hepatitis C (emergency department) or come from elsewhere are referred (red) to us. And (we asked) “How did you get hepatitis C? Oh, let’s talk about your opioid use disorder. Did you know we have medications for opioid use disorder?” And they did… bring the two together. combined with the patient’s treatment.
Jordan Mayberry, PA-C: Yes, that’s right. I think as an application, we’re probably going to spend a lot more time taking care of these patients…so when we talk about treating their hepatitis C, that’s probably when we can also address the other major issues of these Nursing issues for patient populations.
Anthony Martinez, MD: I think that’s important for building trust, right? The time you are able to spend with your patient to truly build that relationship is critical.
Transcript generated by artificial intelligence and edited for clarity and readability.