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吸毒者在丙型肝炎治疗连续过程中的参与情况。

Engagement in the Hepatitis C care continuum among people who use drugs.

作者信息

Tofighi Babak, Lee Joshua D, Sindhu Selena S, Chemi Chemi, Leonard Noelle R

机构信息

New York University School of Medicine, Department of Population Health.

New York University School of Medicine, Division of General Internal Medicine.

出版信息

J Subst Use. 2020;25(4):343-349. doi: 10.1080/14659891.2019.1704076. Epub 2020 Jan 1.

DOI:10.1080/14659891.2019.1704076
PMID:33041652
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7540221/
Abstract

Despite high rates of Hepatitis C virus (HCV) infection among people who use drugs (PWUDs), access to the HCV care continuum combined with the receipt of medications for addiction treatment in primary care settings remains suboptimal. A qualitative study was conducted among adults admitted for inpatient detoxification for opioid use disorder (OUD) in New York City (n=23) to assess barriers and facilitators with HCV prevention, screening, treatment, interactions with primary care providers, and experiences with integrated care approaches. Study findings yielded six major themes related to HCV care. Major gaps persist in knowledge regarding HCV harm reduction strategies, voluntary HCV testing services, and eligibility for HCV treatment. Treatment coordination challenges reinforce the importance of enhancing linkages to HCV care in key access-points utilized by PWUDs (e.g., emergency rooms, specialty addiction treatment settings). Peer networks combined with frequent patient-physician communication were elicited as important factors in facilitating linkage to HCV care. Additional care coordination needs in primary care settings included access to integrated treatment of HCV and OUD, and administrative support for enrollment in Medicaid, subsidized housing, and access to transportation vouchers.

摘要

尽管吸毒者中丙型肝炎病毒(HCV)感染率很高,但在初级保健机构中获得连续的丙型肝炎护理并同时接受成瘾治疗药物的情况仍不理想。在纽约市因阿片类药物使用障碍(OUD)而住院戒毒的成年人中开展了一项定性研究(n = 23),以评估丙型肝炎预防、筛查、治疗的障碍和促进因素,与初级保健提供者的互动,以及综合护理方法的体验。研究结果产生了与丙型肝炎护理相关的六个主要主题。在丙型肝炎危害降低策略、自愿丙型肝炎检测服务以及丙型肝炎治疗资格方面,知识上仍存在重大差距。治疗协调方面的挑战凸显了在吸毒者使用的关键接入点(如急诊室、专科成瘾治疗机构)加强与丙型肝炎护理联系的重要性。同伴网络以及患者与医生之间的频繁沟通被认为是促进与丙型肝炎护理联系的重要因素。初级保健机构的其他护理协调需求包括获得丙型肝炎和阿片类药物使用障碍的综合治疗,以及在医疗补助登记、补贴住房和交通券获取方面的行政支持。

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本文引用的文献

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'Hep C's like the common cold': understanding barriers along the HCV care continuum among young people who inject drugs.“丙型肝炎就像普通感冒一样”:了解注射吸毒者中丙型肝炎病毒护理连续体中的障碍。
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Knowledge of hepatitis C status moderates the relationship between history of drug treatment and sterile syringe use.对丙型肝炎状态的了解可以调节药物治疗史与使用无菌注射器之间的关系。
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Increases in Acute Hepatitis C Virus Infection Related to a Growing Opioid Epidemic and Associated Injection Drug Use, United States, 2004 to 2014.2004 年至 2014 年美国与阿片类药物流行及相关注射吸毒相关的急性丙型肝炎病毒感染增加。
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"Where's My Choice?" An Examination of Veteran and Provider Experiences With Hepatitis C Treatment Through the Veteran Affairs Choice Program.“我的选择在哪里?”通过退伍军人事务部选择计划对退伍军人和医疗服务提供者丙型肝炎治疗经历的考察。
Med Care. 2017 Jul;55 Suppl 7 Suppl 1:S13-S19. doi: 10.1097/MLR.0000000000000706.
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Onsite treatment of HCV infection with direct acting antivirals within an opioid treatment program.在阿片类药物治疗项目中使用直接作用抗病毒药物对丙型肝炎病毒感染进行现场治疗。
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Restrictions for Medicaid Reimbursement of Sofosbuvir for the Treatment of Hepatitis C Virus Infection in the United States.美国医疗补助计划对索磷布韦治疗丙型肝炎病毒感染的报销限制。
Ann Intern Med. 2015 Aug 4;163(3):215-23. doi: 10.7326/M15-0406.
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Adherence during antiviral treatment regimens for chronic hepatitis C: a qualitative study of patient-reported facilitators and barriers.慢性丙型肝炎抗病毒治疗方案的依从性:一项关于患者报告的促进因素和障碍的定性研究。
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