|
|
Learning Objective:
By the end of the presentation participants will be able to:
1. List standardized brief clinical screening tools for psychiatric and substance-use disorders.
2. Describe several models of HCV care integrating medical and psychiatric/substance-use providers.
Background:
The HCV infection rate among veterans receiving care through VHA is estimated at 5.4%, three times that of the general population. Over 80% of HCV+ veterans have either a psychiatric or substance-use disorder and most have both. However, these very disorders have often been cited as reasons to exclude psychiatrically ill veterans from HCV antiviral therapy. The most common treatment, interferon and ribavirin, causes neuropsychiatric side effects, including depression, in 15-40% of individuals. This suggests a very important role for mental health care providers in identifying and treating psychiatric co-morbidity and thus increasing access to antiviral therapy. The Northwest Hepatitis C Resource Center at the Portland VA Medical Center has developed an integrated care model for veterans with HCV as a collaboration between Liver Clinic and Mental-Health/Substance-Abuse providers.
Setting:
Veterans healthcare facility
Population e.g. API Youth, MSM, IDU:
HCV+ veterans seen in Liver, Mental Health, and Substance Abuse Clinics
Project Description:
Workshop providers will present their integrated model as clinical pathways including standardized screening for psychiatric/ substance-use disorders. Other aspects of the model include pre-interferon treatment evaluation, standardized group HCV education, and other patient education products. Providers will share their clinical experiences and previously published outcome data in implementing this model and make suggestions for using it as a modular intervention adaptable to various settings.
Results/Lessons Learned:
Antiviral treatment of HCV+ patients is best provided through integrating medical, psychiatric, and substance-abuse care. Establishing care pathways, group education, and standardized screenings greatly enhances this approach.
Web Page: www.hepatitis.va.gov
See more of F3 - Clinical and Educational Tools for Managing Chronic Hepatitis C VIrus Infection
See more of The 2005 National Viral Hepatitis Prevention Conference