加利福尼亚州注射器交换项目客户中推荐预防性健康服务的未满足需求：对质量改进的影响。
Unmet need for recommended preventive health services among clients of California syringe exchange programs: implications for quality improvement.
作者信息
Heinzerling K G, Kral A H, Flynn N M, Anderson R L, Scott A, Gilbert M L, Asch S M, Bluthenthal R N
机构信息
UCLA Robert Wood Johnson Clinical Scholars Program, 911 Broxton Avenue, Third Floor, Los Angeles, CA 90024, USA.
出版信息
Drug Alcohol Depend. 2006 Feb 1;81(2):167-78. doi: 10.1016/j.drugalcdep.2005.06.008. Epub 2005 Jul 25.
BACKGROUND
Comprehensive preventive services are recommended for injection drug users (IDU), including screening tests, vaccinations, risk reduction counseling, and sterile syringes. Syringe exchange programs (SEP) may facilitate receipt of preventive services by IDUs, but whether SEP clients receive recommended preventive care is not known. We examined use of recommended preventive services by clients of 23 SEPs throughout California.
METHODS
Five hundred and sixty SEP clients were recruited from 23 SEPs throughout California between March and September 2003. Receipt of 10 recommended preventive services and source of care (SEP versus non-SEP providers) was ascertained from client interviews.
RESULTS
On average, SEP clients received only 13% of recommended preventive services and 49% of clients received none of the recommended services. Of services that were received, 76% were received from SEPs. In multivariate analysis, use of drug treatment and more frequent SEP visits were associated with receipt of recommended preventive services by clients.
CONCLUSIONS
SEPs are often the only source of preventive care for their IDU clients. Still, SEP clients fail to receive most recommended preventive services. Interventions to increase use of preventive services and improve the quality of preventive care received by IDUs, such as increased access to drug treatment and SEPs, are needed.
背景
建议为注射吸毒者提供全面的预防服务，包括筛查测试、疫苗接种、降低风险咨询和无菌注射器。注射器交换项目（SEP）可能有助于注射吸毒者获得预防服务，但SEP的客户是否接受了推荐的预防保健尚不清楚。我们调查了加利福尼亚州23个SEP的客户对推荐预防服务的使用情况。
方法
2003年3月至9月期间，从加利福尼亚州的23个SEP中招募了560名SEP客户。通过客户访谈确定了10项推荐预防服务的接受情况以及护理来源（SEP与非SEP提供者）。
结果
SEP客户平均仅接受了13%的推荐预防服务，49%的客户未接受任何推荐服务。在已接受的服务中，76%是从SEP获得的。在多变量分析中，接受药物治疗和更频繁地访问SEP与客户接受推荐预防服务相关。
结论
SEP通常是其注射吸毒者客户预防保健的唯一来源。尽管如此，SEP客户仍未接受大多数推荐的预防服务。需要采取干预措施，以增加预防服务的使用并提高注射吸毒者接受的预防保健质量，例如增加获得药物治疗和SEP的机会。
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