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苏格兰泰赛德地区通过社区药房进行干血斑检测的准实验性评估。

A quasi-experimental evaluation of dried blood spot testing through community pharmacies in the Tayside region of Scotland.

作者信息

Radley Andrew, Melville Karen, Tait Jan, Stephens Brian, Evans Josie M M, Dillon John F

机构信息

NHS Tayside, Directorate of Public Health, Kings Cross Hospital, Dundee, UK.

NHS Tayside, Tayside Substance Misuse Services, Dundee, UK.

出版信息

Frontline Gastroenterol. 2017 Jul;8(3):221-228. doi: 10.1136/flgastro-2016-100776. Epub 2017 Jan 6.

Abstract

OBJECTIVE

Comparison of uptake of dried blood spot testing (DBST) for hepatitis C virus (HCV) infection between community pharmacies and established services.

DESIGN

Quantitative evaluation of a service development with qualitative process evaluation undertaken in parallel.

SETTING

Six pharmacies from 36 community pharmacies within Dundee City, a large urban settlement with high levels of socioeconomic deprivation.

PARTICIPANTS

Patients in receipt of opioid substitution therapy (OST) not tested for HCV within 12 months. The 6 pharmacies provided OST for approximately 363 patients from a cohort of 1385 patients within Dundee City.

INTERVENTION

Provision of DBST by pharmacists.

MAIN OUTCOME MEASURE

Receipt of DBST between January and December 2014.

RESULTS

43 of 143 service users with no record of testing from the 6 community pharmacies accepted DBST. Of 561 from the remaining 1022 service users with no record of testing, 75 were tested for HCV (30% vs 13%). The OR for increased uptake of testing within the 6 pharmacies was 2.25 (95% CI 1.48 to 3.41, Z statistic=3.81, p=<0.0001) compared with other services. The DBST taken by the pharmacies provided 12 patients with a reactive test. The process evaluation identified key themes important to staff and recipients of the service. A logic model was constructed.

LIMITATIONS

Non-experimental service evaluation performed in community pharmacies records service activity in one location across a single time period.

INTERPRETATION

Some evidence that DBST from community pharmacies may be feasible. Service users received the service positively. Staff reported that DBST was straightforward and achievable.

摘要

目的

比较社区药房与现有服务机构对丙型肝炎病毒(HCV)感染进行干血斑检测(DBST)的接受情况。

设计

对一项服务发展进行定量评估,并同时进行定性过程评估。

地点

邓迪市36家社区药房中的6家,邓迪市是一个社会经济贫困程度较高的大型城市聚居地。

参与者

接受阿片类药物替代疗法(OST)且在12个月内未接受HCV检测的患者。这6家药房为邓迪市1385名患者中的约363名患者提供OST。

干预措施

药剂师提供DBST。

主要观察指标

2014年1月至12月期间接受DBST的情况。

结果

6家社区药房中143名无检测记录的服务使用者中有43人接受了DBST。在其余1022名无检测记录的服务使用者中的561人中,有75人接受了HCV检测(30%对13%)。与其他服务相比,这6家药房检测接受率增加的比值比为2.25(95%可信区间1.48至3.41,Z统计量=3.81,p<0.0001)。药房采集的DBST检测出12名患者呈阳性。过程评估确定了对服务工作人员和接受者重要的关键主题。构建了一个逻辑模型。

局限性

在社区药房进行的非实验性服务评估记录了一个地点在单个时间段内的服务活动。

解读

有一些证据表明社区药房的DBST可能是可行的。服务使用者对该服务反应积极。工作人员报告称DBST简单易行。

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