Department of Medicine, Jacobs School of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University at Buffalo, Buffalo, New York, USA.
School of Nursing, Division of Biobehavioral Health and Clinical Sciences, University at Buffalo, Buffalo, New York, USA.
Health Expect. 2023 Dec;26(6):2594-2607. doi: 10.1111/hex.13854. Epub 2023 Aug 28.
People who use drugs (PWUD) frequently delay or avoid obtaining medical care in traditional healthcare settings. Through a randomized controlled trial, we investigated facilitated telemedicine for hepatitis C virus (HCV) integrated into opioid treatment programmes. We sought to understand the experiences and meanings of facilitated telemedicine and an HCV cure among PWUD.
We utilized purposive sampling to interview 25 participants, 6-40 months after achieving an HCV cure. We interpreted and explicated common meanings of participants' experiences of an HCV cure obtained through facilitated telemedicine.
Participants embraced facilitated telemedicine integrated into opioid treatment programmes as patient-centred care delivered in 'safe spaces' (Theme 1). Participants elucidated their experiences of substance use and HCV while committing to treatment for both entities. Facilitated telemedicine integrated into opioid treatment programmes enabled participants to avoid stigma encountered in conventional healthcare settings (Theme 2). Participants conveyed facing negative perceptions of HCV and substance use disorder. Improved self-awareness, acquired through HCV and substance use treatment, enabled participants to develop strategies to address shame and stigma (Theme 3). An HCV cure, considered by PWUD as a victory over a lethal infectious disease, promotes self-confidence, enabling participants to improve their health and lives (Theme 4).
Integrating facilitated telemedicine into opioid treatment programmes addresses several healthcare barriers for PWUD. Similarly, obtaining an HCV cure increases their self-confidence, permissive to positive lifestyle changes and mitigating the negative consequences of substance use.
In this study of patient involvement, we interviewed patient-participants to understand the meaning of an HCV cure through facilitated telemedicine. Participants from a facilitated telemedicine pilot study provided essential input on the design and outcomes of a randomized controlled trial. Pilot study participants endorsed facilitated telemedicine in a testimonial video. They attended site initiation meetings to guide trial implementation. A Patient Advisory Committee (PAC) ensured that patient participants were active members of the research team. The PAC represented patients' voices through feedback on study procedures. A Sustainability Committee supported public involvement in the research process, including educational opportunities, feedback on implementation, and future sustainability considerations.
吸毒者（PWUD）经常在传统医疗保健环境中延迟或避免获得医疗保健。通过一项随机对照试验，我们调查了将促进型远程医疗纳入阿片类药物治疗计划以治疗丙型肝炎病毒（HCV）的情况。我们试图了解 PWUD 通过促进型远程医疗治疗 HCV 并实现 HCV 治愈的体验和意义。
我们采用了目的性抽样方法，对 25 名参与者进行了采访，他们在 HCV 治愈后 6-40 个月。我们对参与者通过促进型远程医疗获得 HCV 治愈的体验的共同意义进行了解释和说明。
参与者将整合到阿片类药物治疗计划中的促进型远程医疗视为在“安全空间”中提供的以患者为中心的护理（主题 1）。参与者阐明了他们在承诺治疗 HCV 和物质使用障碍的同时使用物质和感染 HCV 的经历。整合到阿片类药物治疗计划中的促进型远程医疗使参与者能够避免在传统医疗保健环境中遇到的污名（主题 2）。参与者传达了对 HCV 和物质使用障碍的负面看法。通过 HCV 和物质使用治疗获得的自我意识提高，使参与者能够制定策略来应对羞耻感和污名（主题 3）。HCV 治愈被 PWUD 视为战胜致命传染病的胜利，增强了他们的自信，使他们能够改善自己的健康和生活（主题 4）。
将促进型远程医疗整合到阿片类药物治疗计划中可以解决 PWUD 的一些医疗保健障碍。同样，获得 HCV 治愈可以增强他们的自信心，允许他们进行积极的生活方式改变，并减轻物质使用的负面影响。
在这项关于患者参与的研究中，我们采访了患者参与者，以了解通过促进型远程医疗获得 HCV 治愈的意义。来自促进型远程医疗试点研究的参与者就随机对照试验的设计和结果提供了重要意见。试点研究参与者在宣传视频中对促进型远程医疗表示认可。他们参加了启动会议以指导试验的实施。患者咨询委员会（PAC）确保患者参与者是研究团队的积极成员。PAC 通过对研究程序的反馈来表达患者的声音。可持续性委员会支持公众参与研究过程，包括教育机会、对实施的反馈以及未来的可持续性考虑。
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