无家可归人群中艾滋病毒、丙型肝炎和结核病治疗依从性系统评价方案。
Protocol for a systematic review of treatment adherence for HIV, hepatitis C and tuberculosis among homeless populations.
作者信息
Johnson Luke, Lewer Dan, Aldridge Robert W, Hayward Andrew C, Story Alistair
机构信息
Collaborative Centre for Inclusion Health, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HT, UK.
Department of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, SO17 1BJ, UK.
出版信息
Syst Rev. 2020 Sep 13;9(1):211. doi: 10.1186/s13643-020-01470-y.
BACKGROUND
Homelessness is a global issue and HIV, hepatitis C and tuberculosis are known to be prevalent in this group. Homeless populations face significant barriers to care. We aim to summarise evidence of treatment initiation and completion for homeless populations with these infections, and their associated factors, through a systematic review and meta-analysis.
METHODS
We will search MEDLINE, Embase and CINAHL for all study types and conference abstracts looking at either (1) treatment initiation in a cohort experiencing homelessness with at least one of HIV, hepatitis C, active tuberculosis and/or latent tuberculosis infection (LTBI); (2) treatment completion for those who initiated treatment. We will perform a meta-analysis of the proportion of those with each infection who initiate and complete treatment, as well as analysis of individual and health system factors that may affect adherence levels. We will evaluate the quality of research papers using the Newcastle-Ottawa scale.
DISCUSSION
Given the political emphasis on global elimination of these diseases, and the current lack of understanding of effective and equitable treatment adherence strategies in homeless populations, this review will provide insight to policy-makers and service providers aiming to improve homeless healthcare.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42019153150.
背景
无家可归是一个全球性问题，已知艾滋病毒、丙型肝炎和结核病在这一群体中普遍存在。无家可归者在获得医疗护理方面面临重大障碍。我们旨在通过系统评价和荟萃分析，总结感染这些疾病的无家可归者开始治疗和完成治疗的证据及其相关因素。
方法
我们将检索MEDLINE、Embase和CINAHL，查找所有研究类型和会议摘要，这些摘要涉及以下内容之一：（1）在患有艾滋病毒、丙型肝炎、活动性结核病和/或潜伏性结核感染（LTBI）中至少一种疾病的无家可归队列中开始治疗的情况；（2）已开始治疗者的治疗完成情况。我们将对每种感染中开始治疗和完成治疗的比例进行荟萃分析，并分析可能影响依从性水平的个人因素和卫生系统因素。我们将使用纽卡斯尔-渥太华量表评估研究论文的质量。
讨论
鉴于政治上强调全球消除这些疾病，以及目前对无家可归者有效和公平的治疗依从性策略缺乏了解，本综述将为旨在改善无家可归者医疗保健的政策制定者和服务提供者提供见解。
系统评价注册
PROSPERO CRD42019153150。
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