Integration of hepatitis C treatment at harm reduction centers in Georgia-Findings from a patient satisfaction survey.
Integration of hepatitis C treatment at harm reduction centers in Georgia-Findings from a patient satisfaction survey.
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DOI：
10.1016/j.drugpo.2020.102893
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发表时间：
2020-10
期刊：
影响因子：
--
通讯作者：
Averhoff F
中科院分区：
文献类型：
--
作者：
Butsashvili M;Kamkamidze G;Kajaia M;Gvinjilia L;Kuchuloria T;Khonelidze I;Gogia M;Dolmazashvili E;Kerashvili V;Zakalashvili M;Shadaker S;Nasrullah M;Sonjelle S;Japaridze M;Averhoff F
格鲁吉亚于2015年启动了全国丙型肝炎病毒消除计划。PWID在获得HCV治疗方面可能遇到障碍。为了改善PWID患者与护理的联系，启动了将HCV治疗与阿片替代治疗（OST）中心和针头注射计划（NSP）站点的人力资源服务相结合的试点项目。我们的研究旨在评估患者对人力资源中心综合HCV治疗服务的满意度。对在5个综合护理点和4个不提供人力资源服务的专科诊所接受HCV治疗的方便样本进行了调查。在OST/NSP中心HCV治疗方案中引入简化的治疗前诊断算法和治疗监测程序，与标准算法相比，减少了治疗前和监测测试。共有358名患者参与了调查，其中48.6%的患者在专科诊所接受HCV治疗，51.4%的患者在人力资源中心接受综合治疗。在人力资源中心（88.0%）和诊所（84.5%）接受调查的患者中，有相似比例的人表示，他们在加入消除计划时没有遇到任何障碍。人力资源试验点和专科诊所的大多数患者表示他们获得了全面的治疗信息（98.4% vs 94.3%; p<0.010）。两个地点95%的应答者确信在治疗期间保密得到了完全保护。与专科诊所相比，试验点的患者认为设施提供的丙型肝炎治疗服务良好的比例更高（85.3%对81.0%）。我们发现，从病毒血症检测到首次给药的平均时间在治疗时间上存在显著差异：42.9%的试验点患者和4.6%的专科诊所患者在两周内接受了首次给药。服务质量和接受治疗的患者的感知满意度表明，HCV治疗与人力资源服务的整合是可行的。
Georgia launched national HCV elimination program in 2015. PWID may experience barriers to accessing HCV care. To improve linkage to care among PWID, pilot program to integrate HCV treatment with HR services at opiate substitution therapy (OST) centers and needle syringe program (NSP) sites was initiated. Our study aimed to assess satisfaction of patients with integrated HCV treatment services at HR centers. Survey was conducted among convenience sample of patients receiving HCV treatment at 5 integrated care sites and 4 specialized clinics not providing HR services. Simplified pre-treatment diagnostic algorithm and treatment monitoring procedure was introduced for HCV treatment programs at OST/NSP centers which includes fewer pre-treatment and monitoring tests compared to standard algorithm. In total, 358 patients participated in the survey - 48.6% receiving HCV treatment at the specialized clinics while 51.4% at HR site with integrated treatment. Similar proportions of surveyed patients at HR sites (88.0%) and clinics (84.5%) stated that they did not face any barriers to enrollment in the elimination program. Most patients from HR pilot sites and specialized clinics stated that they received comprehensive information about the treatment (98.4% vs 94.3%; p<0.010). 95% of respondents at both sites were confident that confidentiality was completely protected during treatment. Higher proportion of patients at pilot sites thought that HCV treatment services provided at facility were good compared to those from the specialized clinics (85.3% vs 81.0%). We found significant difference in the time to treatment, measured as average time from viremia testing to administration of first dose of HCV medication: 42.9% of patients at pilot sites vs 4.6% at specialized clinics received the first dose of medication within two weeks. Quality of services and perceived satisfaction of patients receiving treatment, suggests that integration of HCV treatment with HR services is feasible.
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