"She Was Real About It and Made Me Feel Life Is Important": Patient Perspectives on Peers' Role in Peer-Assisted Telemedicine Hepatitis C Treatment for People Who Use Drugs in Rural Communities.

Abstract

Telemedicine is a promising approach to reach people with limited access to treatment for hepatitis C. People who use drugs (PWUD) and are disengaged from services, however, experience barriers to telemedicine access. The Oregon HOPE TeleHCV study employed peer support specialists to provide outreach to engage PWUD, support pretreatment screening, facilitate telemedicine Hepatitis C virus visits, and assist HCV medication initiation and adherence. In our randomized controlled trial (N =203), the model demonstrated substantially higher HCV treatment initiation and cure compared with enhanced usual care. Our qualitative investigation examined the role of peers from the perspective of patients. We conducted semistructured phone interviews with 34 patients to better understand the influence of peer interactions on patient experiences and the role of peer support in shaping patient outcomes. The domains of interest were to better understand (1) the influence of peer interactions on patient experiences and (2) the role of peer support in shaping patient outcomes. Interviews were recorded, professionally transcribed and analyzed using Thematic Analysis. We identified 3 major themes regarding the role of peers in the model: (1) peers' lived experience and ways of engaging with patients create an alliance with patients, (2) peers serve as a communication bridge with the health care system, and (3) peers facilitate access to resources and support. Peers were key to the success of the model. Expansion of the Oregon HOPE TeleHCV model of using peer support specialists to engage, retain, and support PWUD could galvanize efforts to eliminate HCV.