Browsing by Author "Markatou, Marianthi"
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- ItemIntegrated, Co-located, Telemedicine-based Treatment Approaches for Hepatitis C Virus (HCV) Management in Opioid Use Disorder Patients on Methadone.(0000-00-00) Talal, Andrew H; Andrews, Phyllis; McLeod, Anthony; Chen, Yang; Sylvester, Clewert; Markatou, Marianthi; Brown, Lawrence SBackground and aims Despite high hepatitis C virus HCV prevalence opioid use disorder OUD patients on methadone rarely engage in HCV treatment We investigated the effectiveness of HCV management via telemedicine in an opioid substitution therapy OST program Methods OUD patients on methadone underwent biweekly telemedicine sessions between a hepatologist and physician assistant during the entire HCV treatment course All pretreatment labs HCV RNA genotype and noninvasive fibrosis assessments were obtained onsite and direct acting antivirals were co administered with methadone using modified directly observed therapy We used multiple correspondence analysis LASSO and logistic regression to identify variables associated with pursuit of HCV care Results Sixty two HCV RNA positive patients 24 HIV infected 61 male 61 black African American 25 8 Hispanic were evaluated All patients were stabilized on methadone and all except 4 were HCV genotype 1 infected Advanced fibrosis cirrhosis was present in 34 5 of patients Of the 45 treated patients 42 93 3 achieved viral eradication Of 17 evaluated patients who were not treated 5 were discontinued from the drug treatment program or did not follow up after the evaluation 2 had HIV adherence issues and 10 had insurance authorization issues Marriage and a mental health diagnosis other than depression were the strongest positive predictors of treatment pursuit while being divorced separated or widowed was the strongest negative predictor Conclusion HCV management via telemedicine integrated into an OST program is a feasible model with excellent virologic effectiveness Psychosocial and demographic variables can assist in identification of subgroups with a propensity or aversion to pursue HCV treatment
- ItemPatient Reaction to Telemedicine for Clinical Management of Hepatitis C Virus Integrated into an Opioid Treatment Program.(0000-00-00) Talal, Andrew H; McLeod, Anthony; Andrews, Phyllis; Nieves-McGrath, Heidi; Chen, Yang; Reynolds, Andrew; Sylvester, Clewert; Dickerson, Suzanne S; Markatou, Marianthi; Brown, Lawrence SBackground and Introduction Virtual integration of hepatitis C virus HCV infection management within the opioid treatment program OTP through telemedicine may overcome limited treatment uptake encountered when patients are referred offsite To evaluate the diffusion of telemedicine within the OTP we conducted a pilot study to assess acceptance of and satisfaction with telemedicine among 45 HCV infected opioid use disorder OUD patients on methadone MATERIALS AND METHODS We administered a modified 11 item telemedicine satisfaction questionnaire after the initial HCV telemedicine evaluation when initiating HCV treatment and 3 months post HCV treatment completion Among a patient subset a semistructured interview further assessed issues of participant referral to the telemedicine program as well as convenience and confidentiality with the telemedicine encounters RESULTS Patients demonstrated their acceptance of telemedicine based encounters by referral of additional participants They highlighted the convenience of on site treatment with a liver specialist through recognition of the benefit of one stop shopping They also expressed confidence in the privacy and confidentiality of telemedicine encounters DISCUSSION In this pilot study telemedicine appears to be well accepted as a modality for HCV management among OUD patients on methadone Virtual integration of medical and behavioral therapy through telemedicine warrants further investigation for its use in this population CONCLUSIONS In this pilot study we found that a largely racial minority population of substance users grew to accept telemedicine over time with diminished privacy and confidentiality concerns Telemedicine was well accepted within the OTP community as reflected by participant referral to the program
- ItemPDA-based informatics strategies for tobacco use screening and smoking cessation management: a case study.(2007-10-03) Bakken, Suzanne; Roberts, W Dan; Chen, Elizabeth; Dilone, Joann; Lee, Nam-Ju; Mendonca, Eneida; Markatou, MarianthiThe purpose of this case study is to describe three incremental personal digital PDA based informatics strategies aimed at improving screening for tobacco use and guideline based tobacco cessation management 1 PDA clinical log with tobacco cessation diagnoses and plan of care options 2 PDA decision support system and 3 PDA decision support system with infobuttons context specific links to the National Cancer Institute s Cancer Information Services tobacco cessation information These strategies were implemented within the context of an evidence based advanced practice nurse curriculum at the Columbia University School of Nursing