A Pilot Randomised Controlled Trial Involving Financial Incentives to Facilitate Hepatitis C Treatment Uptake Among People Who Inject Drugs: ETHOS Engage Study
Alison D. Marshall,
Anna Conway,
Evan B. Cunningham,
Heather Valerio,
David Silk,
Maryam Alavi,
Shane Tillakeratne,
Alexandra Wade,
Thao Lam,
Krista Zohrab,
Adrian Dunlop,
Craig Connelly,
Victoria Cock,
Carina Burns,
Charles Henderson,
Michael Christmass,
Gregory J. Dore,
Jason Grebely
Affiliations
Alison D. Marshall
The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
Anna Conway
The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
Evan B. Cunningham
The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
Heather Valerio
The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
David Silk
The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
Maryam Alavi
The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
Shane Tillakeratne
The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
Alexandra Wade
Drug and Alcohol Clinical Services, Mid North Coast Local Health District, Kempsey, NSW 2440, Australia
Thao Lam
Drug and Alcohol Clinical Services, Western Sydney Local Health District, Sydney, NSW 2770, Australia
Krista Zohrab
Lismore Liver Clinic, Mid North Coast Local Health District, Lismore, NSW 2480, Australia
Adrian Dunlop
Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, NSW 2302, Australia
Craig Connelly
North Metro Community Alcohol & Drug Service, Joondalup, WA 6027, Australia
Victoria Cock
Drug and Alcohol Services South Australia (DASSA), Adelaide, SA 5069, Australia
Carina Burns
Drug and Alcohol Clinical Services, South Western Sydney Local Health District, Sydney, NSW 2170, Australia
Charles Henderson
NSW Users and AIDS Association, Sydney, NSW 2010, Australia
Michael Christmass
National Drug Research Institute, Curtin University, Perth, WA 6102, Australia
Gregory J. Dore
The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
Jason Grebely
The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
The primary aim of this study was to establish the feasibility of implementing a larger RCT designed to evaluate the effect of financial incentives on HCV treatment initiation among persons receiving opioid agonist therapy and/or who have injected drugs in the prior six months. ETHOS Engage is an observational cohort of participants recruited from drug treatment and needle and syringe programs in Australia. Among 11 drug and alcohol clinics, participants who were HCV RNA-positive were randomized (1:1) to receive standard of care or a AUD $60 gift card at treatment initiation. Regarding feasibility, 100% (57/57) of eligible participants enrolled to take part. Twenty-eight participants were randomised to the financial incentive arm (AUD $60 gift card) plus standard of care and 29 participants to the standard of care arm. In this pilot RCT (n = 57), median age was 42 years (IQR 37–49), 63% were male (n = 36), 35% Indigenous (n = 20) and 36% (n = 21) reported injecting drugs daily in the past month. Twelve weeks post-study enrolment, 11 (39%) participants in the financial incentive arm and 17 (59%) participants in the standard of care arm initiated HCV treatment. Findings indicate high feasibility among people who inject drugs to be randomised to receive financial incentives to initiate HCV treatment.
