我们是否准备好治疗患有阿片类物质使用障碍的丙型肝炎病毒感染者：基于专家生成模型对欧洲国家的准备情况进行评估
Are we ready to treat hepatitis C virus in individuals with opioid use disorder: assessment of readiness in European countries on the basis of an expert-generated model.
作者信息
Wright Nat, Reimer Jens, Somaini Lorenzo, Roncero Carlos, Maremmani Icro, Simon Nicolas, Krajci Peter, Littlewood Richard, D'Agnone Oscar, Alho Hannu, Rolland Benjamin
机构信息
aTransform Research Alliance, Huddersfield University, Huddersfield bApplied Strategic, London cFaculty of Medical and Human Sciences, Institute of Brain Behaviour and Mental Health, Manchester, UK dDepartment of Psychiatry and Psychotherapy, Centre for Interdisciplinary Addiction Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany eAddiction Treatment Centre, Biella fDepartment of Psychiatry, Santa Chiara University Hospital, University of Pisa, Italy gDepartment of Addiction Medicine, University Hospital of Lille, Lille hPharmacology, University Hospital of Lille, Lille iDepartment of Adult Psychiatry and Clinical Pharmacology, Public Assistance Marseillie Hospital, Sainte Marguerite Hospital, Marseille, France jDepartment of Psychiatry, Addiction and Dual Diagnosis Unit, Vall d'Hebron University Hospital, Biomedical Research Center Network of Mental Health, Autonomous University of Barcelona, Barcelona, Spain kDepartment of Substance Use Disorder Treatment, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway lAbdominal Center, Department of Medicine, University Hospital and University of Helsinki, Helsinki, Finland.
出版信息
Eur J Gastroenterol Hepatol. 2017 Nov;29(11):1206-1214. doi: 10.1097/MEG.0000000000000962.
Individuals with a history of injecting drugs have a high prevalence of chronic hepatitis C (HCV) infection. Many have a history of opioid use disorder (OUD). Despite novel treatments with improved efficacy and tolerability, treatment is limited in the group. A faculty of experts shared insights from clinical practice to develop an HCV care-readiness model. Evidence and expert knowledge was collected. Ten experts developed a model of three factors (with measures): 'healthcare engagement', 'guidance' and 'place'. Overall, 40-90% of individuals with OUD engage with drug treatment services. Ten of 12 HCV guidelines provided specific advice for the OUD population. Ten of 12 OUD care guidelines provided useful HCV care advice. In 11 of 12 cases, location of HCV/drug treatment care was in different places. This readiness assessment shows that there are important limitations to successful HCV care in OUD. Specific actions should be taken: maintain/increase access to OUD treatment services/opioid agonist therapy, updating HCV guidance, locate care in the same place and allow wider prescribing of anti HCV medicines.
有注射毒品史的个体慢性丙型肝炎（HCV）感染率很高。许多人有阿片类物质使用障碍（OUD）病史。尽管有疗效和耐受性有所改善的新型治疗方法，但该群体的治疗仍很有限。一组专家分享了临床实践中的见解，以制定一个HCV治疗准备模型。收集了证据和专家知识。十位专家制定了一个包含三个因素（及相关措施）的模型：“医疗保健参与度”、“指导”和“地点”。总体而言，40%至90%的OUD患者接受药物治疗服务。12项HCV指南中有10项为OUD人群提供了具体建议。12项OUD护理指南中有10项提供了有用的HCV护理建议。在12个案例中的11个中，HCV/药物治疗护理的地点不同。这种准备情况评估表明，在OUD患者中成功进行HCV护理存在重要限制。应采取具体行动：维持/增加获得OUD治疗服务/阿片类激动剂治疗的机会，更新HCV指南，将护理地点设在同一地方，并允许更广泛地开具抗HCV药物处方。
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