Nightingale Rebecca, Griffiths Paul, Mortimer Kevin, Walker Paul, Byrne Tara, Marwood Kerry, Morrison-Griffiths Sally, Renwick Sue, Rylance Jamie, Burhan Hassan
Liverpool School of Tropical Medicine, Liverpool, UK
Royal Liverpool and Broadgreen University Hospitals, Liverpool, UK.
BJGP Open. 2020 Aug 25;4(3). doi: 10.3399/bjgpopen20X101055. Print 2020 Aug.
Smoking rather than injecting heroin has become more common over the last 20 years. Although there is an increasing body of evidence describing high levels of chronic obstructive pulmonary disease (COPD) in people who smoke heroin, there is limited evidence documenting the impact of the long-term condition on this population group.
This study aimed to describe the experiences of people who smoke heroin with COPD in Liverpool, UK.
DESIGN & SETTING: Participants were purposefully sampled for this qualitative study. They included adults enrolled in an opioid replacement clinic run by Addaction in Liverpool, who had already engaged with spirometry testing for COPD as part of a previous study.
Semi-structured interviews were performed with participants with spirometrically confirmed COPD in opioid replacement clinics. Data were analysed using a framework analysis approach.
Sixteen potential participants were invited to take part in the study, of which 10 agreed and were interviewed. Three themes common to all interviews were identified: functional measures of lung health that impacted on their activities of daily living; inhaler and medication perceptions with erratic use that was not concordant with their prescription; and the impact of difficulties accessing care.
These findings, along with previous studies highlighting the prevalence of COPD in this population, warrant efforts to integrate community COPD and opioid replacement services to improve outcomes for this vulnerable population.
在过去20年里，吸食海洛因而非注射海洛因变得更为普遍。尽管有越来越多的证据描述了吸食海洛因者中慢性阻塞性肺疾病（COPD）的高发情况，但记录这种长期疾病对该人群影响的证据有限。
本研究旨在描述英国利物浦吸食海洛因且患有慢性阻塞性肺疾病者的经历。
本定性研究采用目的抽样法选取参与者。他们包括在利物浦由Addaction运营的阿片类药物替代诊所登记的成年人，这些人作为先前一项研究的一部分，已经接受了慢性阻塞性肺疾病的肺活量测定测试。
在阿片类药物替代诊所对肺活量测定确诊为慢性阻塞性肺疾病的参与者进行半结构式访谈。采用框架分析法对数据进行分析。
邀请了16名潜在参与者参与研究，其中10人同意并接受了访谈。确定了所有访谈共有的三个主题：影响其日常生活活动的肺部健康功能指标；吸入器和药物认知以及与处方不一致的不规律使用情况；以及获得护理困难的影响。
这些发现，连同先前强调该人群中慢性阻塞性肺疾病患病率的研究，有必要努力整合社区慢性阻塞性肺疾病和阿片类药物替代服务，以改善这一弱势群体的治疗效果。
