Intervention – integrated HCV treatment
OAT
INFECTIOUS DISEASES
All assessments and medications for participants in the integrated treatment groups were provided onsite at the OAT clinics or CCCs, including DAAs, blood samples, and FSS-9 assessments. Compared with participants in the standard treatment group, participants in the integrated treatment group had no follow-ups in the referral hospital, and they received all assessments and medications at the local OAT clinics or CCC. In addition, they drew only two blood samples; prior to HCV treatment and at EOT12, and blood samples drawn every four weeks during the HCV treatment were not necessary. Integrated treatment was delivered at OAT clinics and CCC by multidisciplinary teams in both of the settings. The OAT clinics differed from the CCCs by offering OAT medications in addition to psychosocial approaches. The multidisciplinary teams at the OAT clinics were equipped with consultants in addiction medicine who were responsible for the OAT and other medical follow-ups and also psychologists providing mental health treatment. In both OAT and CCC settings, nurses and social workers, in cooperation with peer counselors, provided most of the participants’ daily follow-ups. All these professionals were existing clinical staff who closely worked together with the research nurses in management of the interventions and evaluations during the study period. For those eligible for HCV treatment, DAAs were administered by a nurse at OAT clinics/CCCs after a prescription from a consultant in infectious diseases. Contrary to standard HCV treatment, all HCV treatment and scheduled follow-ups during treatment were given in parallel with the observed intake of OAT medications and other care, in line with the study protocol. The number of deliveries of OAT and DAA medications per week was adapted to the level of functioning of each participant. For the most severely ill participants with the lowest level of daily functioning and high intake of multiple drugs, OAT medications and HCV treatment were usually dispensed daily in the OAT clinic, and intake was observed by a nurse. The multidisciplinary team planned assessments with participants, or drop-in approaches were applied.