Inner City Health and Wellness Program, Royal Alexandra Hospital, Edmonton, Canada.
School of Public Health, University of Alberta, Edmonton, Canada.
Drug Alcohol Rev. 2019 May;38(4):423-427. doi: 10.1111/dar.12930. Epub 2019 Apr 25.
Injection drug use is associated with significant morbidity and mortality worldwide. Needle and syringe programs (NSP) have been shown to reduce negative health outcomes for people who inject drugs. However, NSPs have limited reach in hospitals, and no peer-reviewed research has examined NSP implementation in acute care settings. We describe the implementation of an inpatient NSP offered through an addiction medicine consultation service in a large, urban acute care hospital in Edmonton, Canada, and compared characteristics of inpatients who did versus did not access the NSP.
Administrative data were reviewed for all addiction medicine consult service intakes between 11 July 2016 and 14 January 2018. We calculated the proportion of intakes in which patients: (i) were offered syringes; and (ii) accepted syringes. Multivariate analyses were used to examine associations between these outcomes and patient age and sex.
Patients reported injecting drugs in 597 (31%) of 1907 intakes during the study period. People who inject drugs were offered syringes in 334 (56%) of these intakes, and accepted syringes in 124 (37%) of them. Female patients were more likely to accept syringes.
In a recently implemented NSP for hospital inpatients, just over half of patients who reported injection drug use were offered syringes, and the rate of patient acceptance was low. Further research is necessary to describe best practice for inpatient NSPs and identify and remove any barriers that prevent some inpatients from either being offered or accepting syringes.
注射毒品在全球范围内与重大发病率和死亡率相关。已证实,为注射毒品者提供的针具和注射器方案(NSP)可降低其负面健康后果。然而,NSP 在医院的覆盖范围有限,并且没有经过同行评审的研究检验过在急性护理环境中实施 NSP。我们描述了在加拿大埃德蒙顿的一家大型城市急性护理医院中,通过成瘾医学咨询服务提供住院 NSP 的实施情况,并比较了使用和未使用 NSP 的住院患者的特征。
对 2016 年 7 月 11 日至 2018 年 1 月 14 日期间的所有成瘾医学咨询服务摄入情况进行了行政数据审查。我们计算了患者:(i)被提供注射器的摄入比例;(ii)接受注射器的比例。使用多变量分析来检验这些结果与患者年龄和性别之间的关联。
在研究期间,1907 次摄入中有 597 次(31%)报告了注射毒品。在这些摄入中,有 334 次(56%)为注射毒品者提供了注射器,其中 124 次(37%)接受了注射器。女性患者更有可能接受注射器。
在最近为医院住院患者实施的 NSP 中,报告注射毒品的患者中只有一半以上被提供了注射器,而患者接受注射器的比例较低。需要进一步研究以描述住院 NSP 的最佳实践,并确定和消除任何阻止某些住院患者获得或接受注射器的障碍。