HCV Treatment Psychosocial Readiness Assessment Tool (HCV-PRAT)

Guide to Interventions & Resources

Immediate Interventions

Resources

Referrals

Motivation

-      Provide education on the course of chronic Hepatitis C infection, the benefits of early treatment, and the potential benefits of eliminating the virus from the body

-      A Guide to Hepatitis C: Making Treatment Decisions

-      A Guide to Hepatitis C: Preparing for Treatment

-      HCV patient support group for sustained peer support and motivation

HCV Health Literacy

-      Educate client about Hepatitis C disease and treatment response

-      www.hcvadvocate.org  www.cdc.gov/hepatitis

-      www.nyc.gov/health

-      HCV patient support group for sustained peer education

Medication Adherence

-    Conduct full adherence  assessment

-    Engage family member or supportive   

     person in treatment adherence plan

-      Mark calendar, set cell phone alarm or other alarm to ring when time to take medication

-      Discuss how to integrate HCV treatment into existing medication regimen

-      HCV Treatment: A Guide to Help You Stay on Treatment

-      Treatment adherence program

-      Directly Observed Therapy/Pill Counts

-      Visiting nurse

-      Specialty pharmacy

-      HCV patient support group

Self-Efficacy

-      Consider Directly Observed Therapy Administering Interferon at the medical provider office/clinic

-      Treatment Side Effect Management

-      A Guide to Help You Stay on Treatment

-      Overcoming Medical Phobias: How to Conquer Fear of Blood, Needles, Doctors, And Dentists

-      HCV patient support group for sustained peer support and motivation

-      Specialty pharmacy for enhanced treatment support

-      Visiting nurse service

Social Stability- Support

-      Explore barriers that interfere with accessing social support (shame, stigma, low self-esteem)

-      ACCESS NYC - a free service that identifies and screens for over 30 City, State and Federal human service benefit programs

-      Case management

-      Social work - mental health

-      HCV patient support group

Alcohol & Substance Use

-      Educate about the effect of alcohol on the liver and on HCV treatment response

-      Educate about risk of continued substance abuse (health and risk of contracting infectious disease)

-      Use motivational interviewing to encourage engagement in harm reduction & recovery services

-      Conduct further structured assessment of alcohol and/or substance use with AUDIT-C, CAGE, ASI-Lite, KMSK

-      Alcohol and HCV – Patient fact sheet

-      1-800-LIFENET - 24 hour mental health crisis hotline and treatment site referral database

-      www.HarmReduction.org – lists all harm reduction program in NYC

-      Substance Abuse Treatment Facility Locator (SAMHSA)

Psychiatric Stability

-      Educate about the possible psychiatric side effects of HCV treatment

-      Provide mental health, psychosocial or psychiatric evaluation if qualified

-      Conduct structured assessment of psychiatric stability with BDI-II, HADS, SCL-90, BPRS

-      1-800-LIFENET: A free 24 hour mental health crisis hotline and referral database for the public

-      Psychiatric or mental health evaluation & ongoing support throughout treatment

-      HCV patient support group

Energy Level

-      Explore patient’s level of daily exercise and dietary habits that might impact sleep and energy level

-      Conduct further structured assessment of fatigue with Fatigue Severity Scale

-      New York City Sleep Center (212) 740-4600

-      Evaluation for medication management of insomnia, fatigue and/or depression

Cognitive Functioning

-      Consider Directly Observed Therapy

-      Verbally describe treatment processes and procedures in detail

-      Inform medical provider that after medication teaching the patient should demonstrate technique back to ensure understanding

-      Ask if a family member or friend can be present to reinforce learning

Adult literacy classes such as:

-      The City University of New York Adult Literacy Program (212) 794-5302

-      Literacy Partners Inc  (212) 725-9200)

-      Dealing with Cognitive Dysfunction

-      Specialty pharmacy that will provide reinforcement of teaching

-      Treatment adherence program

-      Psychiatric or neurological consult, brain imaging, and or/neuropsychological testing