Butsashvili Maia, Kamkamidze George, Kajaia Maia, Gvinjilia Lia, Kuchuloria Tatia, Khonelidze Irma, Gogia Maka, Dolmazashvili Ekaterine, Kerashvili Vakhtang, Zakalashvili Mamuka, Shadaker Shaun, Nasrullah Muazzam, Sonjelle Shilton, Japaridze Maia, Averhoff Francisco
Health Research Union/Clinic NEOLAB, 8 Nutsubidze str. Tbilisi 0177, Georgia.
Health Research Union/Clinic NEOLAB, 8 Nutsubidze str. Tbilisi 0177, Georgia.
Int J Drug Policy. 2020 Oct;84:102893. doi: 10.1016/j.drugpo.2020.102893. Epub 2020 Jul 31.
Georgia launched national HCV elimination program in 2015. PWID may experience barriers to accessing HCV care. To improve linkage to care among PWID, pilot program to integrate HCV treatment with HR services at opiate substitution therapy (OST) centers and needle syringe program (NSP) sites was initiated. Our study aimed to assess satisfaction of patients with integrated HCV treatment services at HR centers.
Survey was conducted among convenience sample of patients receiving HCV treatment at 5 integrated care sites and 4 specialized clinics not providing HR services. Simplified pre-treatment diagnostic algorithm and treatment monitoring procedure was introduced for HCV treatment programs at OST/NSP centers which includes fewer pre-treatment and monitoring tests compared to standard algorithm.
In total, 358 patients participated in the survey - 48.6% receiving HCV treatment at the specialized clinics while 51.4% at HR site with integrated treatment. Similar proportions of surveyed patients at HR sites (88.0%) and clinics (84.5%) stated that they did not face any barriers to enrollment in the elimination program. Most patients from HR pilot sites and specialized clinics stated that they received comprehensive information about the treatment (98.4% vs 94.3%; p<0.010). 95% of respondents at both sites were confident that confidentiality was completely protected during treatment. Higher proportion of patients at pilot sites thought that HCV treatment services provided at facility were good compared to those from the specialized clinics (85.3% vs 81.0%). We found significant difference in the time to treatment, measured as average time from viremia testing to administration of first dose of HCV medication: 42.9% of patients at pilot sites vs 4.6% at specialized clinics received the first dose of medication within two weeks.
Quality of services and perceived satisfaction of patients receiving treatment, suggests that integration of HCV treatment with HR services is feasible.
格鲁吉亚于2015年启动了全国丙型肝炎消除计划。注射吸毒者在获得丙型肝炎治疗方面可能会遇到障碍。为了改善注射吸毒者与治疗的联系，启动了一项试点计划，将丙型肝炎治疗与阿片类药物替代治疗（OST）中心和针头注射器计划（NSP）场所的人力资源服务相结合。我们的研究旨在评估患者对人力资源中心综合丙型肝炎治疗服务的满意度。
对在5个综合护理场所和4个不提供人力资源服务的专科诊所接受丙型肝炎治疗的患者进行便利抽样调查。为OST/NSP中心的丙型肝炎治疗项目引入了简化的治疗前诊断算法和治疗监测程序，与标准算法相比，该程序包括更少的治疗前和监测测试。
共有358名患者参与了调查，其中48.6%在专科诊所接受丙型肝炎治疗，51.4%在接受综合治疗的人力资源场所接受治疗。在人力资源场所（88.0%）和诊所（84.5%）接受调查的患者中，有相似比例的人表示他们在加入消除计划时没有遇到任何障碍。大多数来自人力资源试点场所和专科诊所的患者表示他们收到了关于治疗的全面信息（98.4%对94.3%；p<0.010）。两个场所95%的受访者相信在治疗期间保密性得到了完全保护。与专科诊所的患者相比，试点场所中认为设施提供的丙型肝炎治疗服务良好的患者比例更高（85.3%对81.0%）。我们发现治疗时间存在显著差异，以从病毒血症检测到首次服用丙型肝炎药物的平均时间来衡量：试点场所42.9%的患者与专科诊所4.6%的患者在两周内接受了首剂药物治疗。
接受治疗患者的服务质量和感知满意度表明，将丙型肝炎治疗与人力资源服务相结合是可行的。
