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利用患者对团体治疗的感知来探索丙型肝炎注射吸毒者的药物依从性、社会支持和生活质量结果。

Utilizing patient perception of group treatment in exploring medication adherence, social support, and quality of life outcomes in people who inject drugs with hepatitis C.

机构信息

Department of Public Health Sciences, Clemson University, Clemson, SC, USA.

Clemson University School of Health Research, Clemson, SC, USA; Department of Medicine, Prisma Health-Upstate, Greenville, SC, USA.

出版信息

J Subst Abuse Treat. 2021 Jul;126:108459. doi: 10.1016/j.jsat.2021.108459. Epub 2021 May 7.

Abstract

People who inject drugs (PWID) have a high prevalence of hepatitis C virus (HCV). Group treatment is a practical option for addressing barriers to treatment in this population. Prior research on group treatment has resulted in mixed conclusions about its effectiveness in addressing barriers to treatment. A patient's perception of the group environment may help to explain this variability. This study sought to explore the association between indicators of group treatment environment and improved outcomes in HCV-infected PWID. This secondary analysis of a randomized controlled trial exploring different models of treatment for HCV in a PWID population consisted of 42 participants randomized to the group treatment branch of the trial. Independent variables consisted of group sessions attended and group climate constructs of engagement, conflict, and avoidance. Dependent variables consisted of medication adherence, social support, and health-related quality of life. The study implemented generalized estimating equations to assess associations with the outcomes at the end of treatment. Factors indicative of group treatment environment were related to medication adherence and other barriers to health for HCV-infected PWID: social support and health-related quality of life. Perceptions of conflict or avoidance were associated with worse outcomes, while increased session attendance was generally associated with better outcomes. The study attests to the importance of examining group environment factors during treatment interventions. Although preliminary, the study provides specific indicators of treatment success for HCV-infected PWID and practical implications to improve patients' health outcomes and better tailor treatment to the patient.

摘要

注射毒品的人(PWID)中丙型肝炎病毒(HCV)的感染率很高。团体治疗是解决该人群治疗障碍的一种切实可行的选择。先前关于团体治疗的研究对其在解决治疗障碍方面的有效性得出了混合的结论。患者对团体环境的看法可能有助于解释这种变异性。本研究旨在探讨团体治疗环境指标与 HCV 感染的 PWID 治疗结果改善之间的关联。这是一项对 HCV 治疗不同模式的随机对照试验的二次分析,研究对象为 PWID 人群,共有 42 名参与者被随机分配到试验的团体治疗组。自变量包括参加的团体治疗次数和参与、冲突和回避的团体氛围结构。因变量包括药物依从性、社会支持和健康相关生活质量。研究采用广义估计方程来评估治疗结束时与结果的关联。团体治疗环境的因素与 HCV 感染的 PWID 的药物依从性和其他健康障碍有关:社会支持和健康相关生活质量。冲突或回避的感知与较差的结果相关,而增加治疗次数通常与更好的结果相关。该研究证明了在治疗干预期间检查团体环境因素的重要性。尽管初步研究结果表明,该研究为 HCV 感染的 PWID 提供了具体的治疗成功指标,并为改善患者的健康结果和更好地根据患者情况调整治疗提供了实际意义。

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