A randomized controlled trial of a brief behavioral intervention to reduce skin and soft tissue infections among people who inject drugs.
A randomized controlled trial of a brief behavioral intervention to reduce skin and soft tissue infections among people who inject drugs.
复制标题
DOI：
10.1016/j.drugalcdep.2021.108646
复制
发表时间：
2021-04-01
影响因子：
4.2
通讯作者：
Stein MD
中科院分区：
文献类型：
--
作者：
Phillips KT;Stewart C;Anderson BJ;Liebschutz JM;Herman DS;Stein MD
注射吸毒者（PWID）是皮肤和软组织感染（SSTIs）的高危人群，但很少有针对其减少的干预措施。本研究的目的是在一项为期12个月随访的两组随机对照试验中测试短暂皮肤和针头卫生行为干预（skin）的效果。从单个城市医疗中心的住院病房招募PWID (N = 252)，并随机分配到仅评估（AO）条件或SKIN，这是一个包括心理教育，行为技能示范和动机访谈的两期干预。混合效应广义线性模型评估了干预对以下频率的影响：1)自我报告的ssti， 2)未清洁的皮肤注射，以及3)注射。参与者58.3%为男性，59.5%为白人，平均年龄38岁。与AO组相比，SKIN组的性传播感染减少了35% (p= 0.179)，差异接近每年一次感染。与AO相比，skin参与者中未清洁皮肤注射的平均发生率低约66% （IRR=0.34, 95% CI 0.20; 0.59, p< 0.001）。几乎三分之一的参与者报告随访期间没有注射，随访期间皮肤组的平均注射率比AO组低39% （IRR=0.61; 95% CI 0.36; 1.02, p= 0.058）。SKIN干预减少了未清洁的皮肤注射，但与对照组相比，没有显著减少SSTIs。简短的干预可以改善PWID患者的高危行为，并带来有临床意义的结果。
People who inject drugs (PWID) are at high risk for skin and soft tissue infections (SSTIs), but few interventions have targeted their reduction. The goal of the current study was to test the effects of a brief skin and needle hygiene behavioral intervention (SKIN) in a two-group randomized controlled trial with 12-month follow-up. PWID (N = 252) were recruited from inpatient hospital units at a single urban medical center site and randomly assigned to an assessment-only (AO) condition or SKIN, which was a two-session intervention that included psychoeducation, behavioral skills demonstrations, and motivational interviewing. Mixed effects generalized linear models assessed the impact of the intervention on frequency of: 1) self-reported SSTIs, 2) uncleaned skin injections, and 3) injection. Participants were 58.3% male, 59.5% White, and averaged 38 years of age. SKIN participants had 35% fewer SSTIs compared to AO (p=.179), a difference of nearly one infection per year. The mean rate of uncleaned skin injections was about 66% lower (IRR=0.34, 95% CI 0.20; 0.59, p<.001) among SKIN participants compared to AO. Almost one-third of participants reported no injection over follow-up and the mean rate of injection during follow-up was about 39% lower (IRR=0.61; 95% CI 0.36; 1.02, p=.058) among persons randomized to SKIN than AO. The SKIN intervention reduced uncleaned skin injections but did not reduce SSTIs significantly more than a control condition. Brief interventions can improve high-risk practices among PWID and lead to clinically meaningful outcomes.
登录
查看更多内容
影响因子：
4.5
作者：
Fernandes RM;Cary M;Duarte G;Jesus G;Alarcão J;Torre C;Costa S;Costa J;Carneiro AV
通讯作者：
Carneiro AV
影响因子：
3.7
作者：
Hope, Vivian;Kimber, Jo;Ncube, Fortune
通讯作者：
Ncube, Fortune
影响因子：
4.4
作者：
Cooper, Hannah L. F.;Linton, Sabriya;Paz-Bailey, Gabriela
通讯作者：
Paz-Bailey, Gabriela
影响因子：
12.7
作者：
Cooper, Hannah L. F.;West, Brooke;Friedman, Samuel R.
通讯作者：
Friedman, Samuel R.
影响因子：
4.2
作者：
Monteiro, Jordanna;Phillips, Kristina T.;Stein, Michael D.
通讯作者：
Stein, Michael D.