Carmen L. Masson, Kevin L. Delucchi, Jennifer Hettema, Nicole Pepper, Jessica Hall, Nicholas S. Hengl, Michael S. Shopshire, Jennifer K. Manuel, Bradley Shapiro, and James L. Sorensen are with the Department of Psychiatry, Mandana Khalili is with the Department of Medicine, and Hali Hammer is with the Department of Family and Community Medicine, University of California, San Francisco. Courtney McKnight, Albert Min, Ashly E. Jordan, Christopher Young, Lara Coffin, Randy M. Seewald, Henry C. Bodenheimer, Jr, Don C. Des Jarlais, and David C. Perlman are with the Beth Israel Medical Center, New York, NY.
Am J Public Health. 2013 Oct;103(10):e81-8. doi: 10.2105/AJPH.2013.301458. Epub 2013 Aug 15.
We evaluated the efficacy of a hepatitis care coordination intervention to improve linkage to hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccination and clinical evaluation of hepatitis C virus (HCV) infection among methadone maintenance patients.
We conducted a randomized controlled trial of 489 participants from methadone maintenance treatment programs in San Francisco, California, and New York City from February 2008 through June 2011. We randomized participants to a control arm (n = 245) and an intervention arm (n = 244), which included on-site screening, motivational-enhanced education and counseling, on-site vaccination, and case management services.
Compared with the control group, intervention group participants were significantly more likely (odds ratio [OR] = 41.8; 95% confidence interval [CI] = 19.4, 90.0) to receive their first vaccine dose within 30 days and to receive an HCV evaluation within 6 months (OR = 4.10; 95% CI = 2.35, 7.17). A combined intervention adherence outcome that measured adherence to HAV-HBV vaccination, HCV evaluation, or both strongly favored the intervention group (OR = 8.70; 95% CI = 5.56, 13.61).
Hepatitis care coordination was efficacious in increasing adherence to HAV-HBV vaccination and HCV clinical evaluation among methadone patients.
我们评估了一种肝炎护理协调干预措施的效果，该措施旨在提高美沙酮维持治疗患者对甲型肝炎病毒（HAV）和乙型肝炎病毒（HBV）疫苗接种的衔接，并对丙型肝炎病毒（HCV）感染进行临床评估。
我们对加利福尼亚州旧金山和纽约市的美沙酮维持治疗项目中的 489 名参与者进行了一项随机对照试验，研究时间为 2008 年 2 月至 2011 年 6 月。我们将参与者随机分配到对照组（n=245）和干预组（n=244），其中包括现场筛查、强化教育和咨询、现场接种疫苗以及病例管理服务。
与对照组相比，干预组参与者在 30 天内接受第一剂疫苗的可能性显著更高（优势比[OR] = 41.8；95%置信区间[CI] = 19.4，90.0），并且在 6 个月内接受 HCV 评估的可能性也更高（OR = 4.10；95% CI = 2.35，7.17）。一个综合的干预依从性结果，衡量了 HAV-HBV 疫苗接种、HCV 评估或两者的依从性，强烈支持干预组（OR = 8.70；95% CI = 5.56，13.61）。
肝炎护理协调在提高美沙酮患者对 HAV-HBV 疫苗接种和 HCV 临床评估的依从性方面是有效的。
