Adapting to the Times: Evaluating the Efficacy of Telehealth on Hcv Outcomes in a Safety-Net Population

ABSTRACT

Background: The Grady Liver Clinic (GLC) is a primary care-based hepatitis C (HCV) clinic that provides comprehensive care for an urban, primarily African American, underserved patient population at Grady Health System. At the onset of the COVID-19 pandemic, GLC pivoted to using a telehealth model for HCV treatment. With telehealth, treatment visits were conducted via telephone or video and HCV medications could be couriered to patients' residences. We aim to compare outcomes of the HCV telehealth treatment model to traditional, in-person treatment. Method(s) We performed a retrospective chart review of all patients who initiated HCV treatment at GLC from 03/2019-02/ 2020 (Pre-Pandemic) and 03/2020-02/ 2021 (Pandemic). The latter cohort was stratified into three types of visits in-person only, telehealth only, and hybrid (mixture of in-person and telehealth). We compared demographic data and HCV treatment outcomes between groups. Result(s) Patients in pre-pandemic and pandemic cohorts were similar genders, ages, ethnicities, and used similar payor sources. The average number of days from referral to treatment initiation differed between cohorts (52 days vs 92 days) as did the treatment duration (84 vs 56 days). The rate of sustained virologic response (SVR12) was similar between cohorts, with SVR12 obtained in 59% of the pre-pandemic cohort that started treatment (96% of those who completed testing for SVR12) vs 61% of the pandemic cohort that started treatment (95% of those who completed testing for SVR12). A substantial proportion of patients in both groups did not follow-up for SVR12 testing. Importantly, there were similar rates of SVR12 in the pandemic in-person, telehealth, and hybrid subgroups (Figure 1, attached). Conclusion(s) Our results show that virtual delivery of healthcare is as effective as traditional in-person clinic visits for HCV treatment. Our data supports continued use of telehealth to improve access to HCV treatment for a vulnerable patient population who face chronic barriers to healthcare access. (Figure Presented).