Tofighi Babak, Lee Joshua D, Sindhu Selena S, Chemi Chemi, Leonard Noelle R
New York University School of Medicine, Department of Population Health.
New York University School of Medicine, Division of General Internal Medicine.
J Subst Use. 2020;25(4):343-349. doi: 10.1080/14659891.2019.1704076. Epub 2020 Jan 1.
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.
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。