Opioid substitution therapy programs and the national campaign to eliminate hepatitis C virus in Taiwan: Current status and perspectives in a 2022 national survey among medical institutions

Abstract

[[abstract]]Aim: In Taiwan’s national campaign to eliminate hepatitis C virus (HCV) by 2025, HCV infection care cascade among opioid substitution therapy (OST) programs plays a crucial role. By employing a national survey among medical institutions, we aim to examine the current status and perspectives expressed by appropriate personnel in the OST program-affiliated institutions. Methods: We conducted a national survey in 2022 among government-contracted OST programs. The questionnaire consists of items about the running costs, hepatitis care cascade, and other issues in the OST programs to be answered by either case managers or directors. Within the 185 OST programs in the nation, 125 programs (68%) had responses from both types of personnel and were included for subsequent analyses. Results: Of 125 programs, 74 (59%) offered HCV screening and 69 (55%) offered HCV treatment. The correlates of both HCV screening and treatment were similar, including greater urbanity level, providing both methadone and buprenorphine (vs either one alone), hospital-based (vs satellite dispensing), smaller size of daily participants (≤ 500, having 2 or more physicians, having 2 or more nurses, and a team consisting of physician plus ≥2 dedicated staff). Regarding the integration of HCV care with OST program, institutions’ concerns included financial incentive for the patients and the doctors, the accessible resources of equipment and relative training, and the service matching platform to enhance the collaboration between OST and other medical institutes are mentioned. Regarding on-site HCV treatment, the percentage of future willingness to offer was 42% for those OST program with current HCV care cascade but only 11% for those without. Conclusions: The establishment of the HCV care cascade in the OST programs was mainly influenced by the resources of medical collaboration and the human resources. Future investments in these aspects are needed to enhance HCV infection care in the OST programs