Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, 220 Arch Street, 12th Floor, Baltimore, MD, 21201, USA.
University of Maryland School of Pharmacy, Baltimore, MD, USA.
Patient. 2021 Sep;14(5):471-484. doi: 10.1007/s40271-020-00489-6. Epub 2020 Dec 29.
Patient-centered care (PCC) is crucial for value-based care. We aimed to assess PCC dimensions addressed in hepatitis C virus direct-acting antiviral treatment delivery to people who inject drugs.
We conducted a scoping review to identify the studies that described hepatitis C virus treatment delivery to people who inject drugs in the direct-acting antiviral treatment era. We analyzed the included studies against eight PCC dimensions: (1) access to care; (2) coordination and integration of care; (3) continuity and translation; (4) physical comfort; (5) information, education, and communication; (6) emotional support; (7) involvement of family and friends; and (8) respect for individual patient preferences, perceived needs, and values. Additionally, we assessed the use of patient-centered terminology and the recognition of PCC importance and its relevance to treatment outcomes.
None of the identified 36 studies addressed all PCC dimensions (highest seven, lowest two). Our findings revealed that PCC dimensions are prioritized differently and addressed using different approaches and strategies. Studies that used PCC terminology referred to personalized activities, which does not imply comprehensive PCC. About one-third of the studies acknowledged the importance of patient centeredness and two-thirds recognized its relevance to treatment outcomes.
Our findings suggest more engagement of people who inject drugs and comprehensive involvement of their families and friends in hepatitis C virus treatment journey, decisions, and outcomes. The recognition of PCC importance and its relevance to treatment outcomes in the analyzed studies emphasizes the need for more patient-centered hepatitis C virus treatment for people who inject drugs.
以患者为中心的医疗（PCC）对于基于价值的医疗至关重要。我们旨在评估在直接作用抗病毒治疗时代针对注射吸毒者提供丙型肝炎病毒治疗时涉及的 PCC 维度。
我们进行了范围综述，以确定描述直接作用抗病毒治疗时代针对注射吸毒者提供丙型肝炎病毒治疗的研究。我们根据以下八个 PCC 维度分析纳入的研究：（1）获得护理的机会；（2）护理的协调和整合；（3）连续性和转化；（4）身体舒适度；（5）信息、教育和沟通；（6）情感支持；（7）家人和朋友的参与；（8）尊重个体患者的偏好、感知需求和价值观。此外，我们评估了使用以患者为中心的术语以及对 PCC 重要性的认识及其与治疗结果的相关性。
在确定的 36 项研究中，没有一项研究涵盖所有 PCC 维度（最高七个，最低两个）。我们的研究结果表明，PCC 维度的优先级不同，并且使用不同的方法和策略来解决。使用 PCC 术语的研究提到了个性化活动，这并不意味着全面的 PCC。大约三分之一的研究承认以患者为中心的重要性，三分之二的研究认识到其与治疗结果的相关性。
我们的研究结果表明，在丙型肝炎病毒治疗过程中，应更多地让注射吸毒者及其家人和朋友参与，并全面参与治疗决策和结果。在分析的研究中，对 PCC 重要性及其与治疗结果相关性的认识强调了为注射吸毒者提供更以患者为中心的丙型肝炎病毒治疗的必要性。
