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直接作用抗病毒药物时代丙型肝炎治疗的个人、提供者和系统层面障碍和促进因素:澳大利亚普通医疗实践环境中接受治疗的注射吸毒者的经验。

Personal, provider and system level barriers and enablers for hepatitis C treatment in the era of direct-acting antivirals: Experiences of patients who inject drugs accessing treatment in general practice settings in Australia.

机构信息

School of Public Health, The University of Queensland, 288 Herston Road, Herston 4006, QLD, Australia.

出版信息

J Subst Abuse Treat. 2021 Aug;127:108460. doi: 10.1016/j.jsat.2021.108460. Epub 2021 May 8.


DOI:10.1016/j.jsat.2021.108460
PMID:34134878
Abstract

Direct acting antiviral (DAA) treatment has made the elimination of hepatitis C virus (HCV) a realisable global public health goal and people who inject drugs are a key target population. This study investigates barriers and enablers to DAA treatment of HCV in general practice settings in Australia, from the patient perspective. Semi-structured interviews were conducted with 28 patients; of these patients, seventeen participants were currently on opioid agonist therapy, and four were currently injecting drugs. Thematic data analysis was undertaken and a personal, provider and systems framework was used to describe the barriers and enablers to DAA treatment. Results suggest a range of initiatives are required to support the uptake of DAA in general practice settings. These include the provision of formalised peer information and support, and increasing the accessibility of blood tests and liver assessment on-site. Further, there remains a need to address stigma and discrimination affecting people who inject drugs in community healthcare settings.

摘要

直接作用抗病毒(DAA)治疗使消除丙型肝炎病毒(HCV)成为一个可行的全球公共卫生目标,而注射毒品者是一个关键的目标人群。本研究从患者角度出发,调查了澳大利亚普通实践环境中 DAA 治疗 HCV 的障碍和促进因素。对 28 名患者进行了半结构化访谈;其中 17 名参与者正在接受阿片类激动剂治疗,4 名正在注射毒品。进行了主题数据分析,并使用个人、提供者和系统框架来描述 DAA 治疗的障碍和促进因素。结果表明,需要采取一系列举措来支持 DAA 在普通实践环境中的应用。这些举措包括提供正式的同伴信息和支持,并增加现场血液检测和肝脏评估的可及性。此外,仍需要解决影响社区医疗保健环境中注射毒品者的污名化和歧视问题。

相似文献

[1]
Personal, provider and system level barriers and enablers for hepatitis C treatment in the era of direct-acting antivirals: Experiences of patients who inject drugs accessing treatment in general practice settings in Australia.

J Subst Abuse Treat. 2021-8

[2]
Prescribing direct-acting antivirals to treat hepatitis C virus in a general practice setting in Australia: 'so why not do it'?

Intern Med J. 2020-9

[3]
"Everybody living with a chronic disease is entitled to be cured": Challenges and opportunities in scaling up access to direct-acting antiviral hepatitis C virus treatment among people who inject drugs.

Int J Drug Policy. 2020-7

[4]
"I want to get better, but…": identifying the perceptions and experiences of people who inject drugs with respect to evolving hepatitis C virus treatments.

Int J Equity Health. 2021-3-19

[5]
'Treat my whole person, not just my condition': qualitative explorations of hepatitis C care delivery preferences among people who inject drugs.

Addict Sci Clin Pract. 2021-8-12

[6]
"Stigma is where the harm comes from": Exploring expectations and lived experiences of hepatitis C virus post-treatment trajectories among people who inject drugs.

Int J Drug Policy. 2021-10

[7]
Beyond interferon side effects: What residual barriers exist to DAA hepatitis C treatment for people who inject drugs?

PLoS One. 2018-11-30

[8]
Peer to peer communication about hepatitis C treatment amongst people who inject drugs: A longitudinal qualitative study.

Int J Drug Policy. 2021-1

[9]
Progress Towards Elimination of Hepatitis C Infection Among People Who Inject Drugs in Australia: The ETHOS Engage Study.

Clin Infect Dis. 2021-7-1

[10]
Patient and provider perceived barriers and facilitators to direct acting antiviral hepatitis C treatment among priority populations in high income countries: A knowledge synthesis.

Int J Drug Policy. 2021-10

引用本文的文献

[1]
Prescribing direct-acting antivirals for hepatitis C treatment: a scoping review of factors that influence primary care providers.

BMC Prim Care. 2025-5-13

[2]
Practical solutions to resolve social barriers to hepatitis C treatment initiation among people who inject drugs: a qualitative study.

Harm Reduct J. 2024-12-20

[3]
Influence of polysubstance use on the health-related quality of life among people who inject drugs undergoing opioid agonist treatment following treatment for hepatitis c virus.

J Subst Use. 2024

[4]
Cost-Effectiveness of Treating Hepatitis C in Clients on Opioid Agonist Therapy in Community Pharmacies Compared to Primary Healthcare in Australia.

J Viral Hepat. 2025-4

[5]
The Application of Australian Rights Protections to the Use of Hepatitis C Notification Data to Engage People 'Lost to Follow Up'.

Public Health Ethics. 2024-5-17

[6]
Barriers to access to hepatitis C treatment with direct-acting antivirals in people who inject drugs in the community setting.

Harm Reduct J. 2024-4-27

[7]
Clinician barriers, perceptions, and practices in treating patients with hepatitis C virus and substance use disorder in the United States.

Prev Med Rep. 2023-2-13

[8]
Injection drug use in an affluent beachside community in Sydney: An exploratory qualitative study.

Drug Alcohol Rev. 2023-3

[9]
Putting out the welcome mat-A qualitative exploration of service delivery processes and procedures as barriers to treatment-seeking for people who use alcohol and other drugs.

Drug Alcohol Rev. 2023-1

[10]
Retreatment for hepatitis C virus direct acting antiviral therapy virological failure in primary and tertiary settings: the REACH-C cohort.

J Viral Hepat. 2022-5-18

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