COVID-19 Impact on Healthcare and Supportive Services for People Who Use Drugs (PWUDs) in Malaysia.
COVID-19 Impact on Healthcare and Supportive Services for People Who Use Drugs (PWUDs) in Malaysia.
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DOI：
10.3389/fpsyt.2021.630730
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发表时间：
2021
影响因子：
4.7
通讯作者：
Chawarski MC
中科院分区：
文献类型：
--
作者：
Vicknasingam B;Mohd Salleh NA;Chooi WT;Singh D;Mohd Zaharim N;Kamarulzaman A;Chawarski MC
背景资料：马来西亚为应对COVID-19疫情而实施的限制性命令以及医疗保健和其他支持系统内的临时计划或特别变化可能对吸毒者（PWUD）获得医疗保健和/或接受其他支持服务造成障碍。设计图：我们进行了一项主要是定性的研究，以评估服务提供者和接受者在应对COVID-19初期的适应和应对情况。设定值：这项研究涉及槟榔屿、吉兰丹、雪兰莪和梅拉卡等半岛州的几个医疗保健和非政府组织（NGO）。参会人员：美沙酮维持治疗（MMT）方案（n = 2）和艾滋病诊所（n = 3），非政府组织服务的工作人员（n = 4），和MMT患者（n = 9）的医务人员进行了采访，使用半结构化的格式。结果如下：受访者报告了在医疗保健和支持服务中实施的重大组织，方案和治疗方案相关的变化，以及国家实施的移动控制命令（MCO）。旨在减少病人流量和集中在现场服务地点的变化，包括减少亲自访问的频率，增加使用远程医疗资源，以及更多地依赖电信方法与病人和客户保持联系;药物分配协议的变化，包括增加带回家的剂量和放松获得它们的规则，大多数研究参与者报告了将药物运送到患者家中或其家附近的位置。在研究中心，包括艾滋病毒感染者在内的残疾人中没有显著的COVID-19感染率。结论：尽管报告的变化对服务提供者和接受者提出了新的挑战，并导致了一定程度的初始中断，但总体而言，所有参与者都报告成功实施了新引入的限制、法规和方案，并高度遵守这些限制、法规和方案，导致研究中心的治疗中断或中止率相对较低。
Background: Restrictive orders and temporary programmatic or ad hoc changes within healthcare and other supportive systems that were implemented in response to the COVID-19 epidemic in Malaysia may have created hindrances to accessing healthcare and/or receiving other supportive services for people who use drugs (PWUDs). Design: A primarily qualitative study has been conducted to evaluate how service providers and recipients were adapting and coping during the initial periods of the COVID-19 response. Settings: The study engaged several healthcare and non-governmental organizations (NGOs) in the peninsular states of Penang, Kelantan, Selangor, and Melaka. Participants: Medical personnel of methadone maintenance treatment (MMT) programs (n = 2) and HIV clinics (n = 3), staff of NGO services (n = 4), and MMT patients (n = 9) were interviewed using a semi-structured format. Results: Interviewed participants reported significant organizational, programmatic, and treatment protocols related changes implemented within the healthcare and support services in addition to nationally imposed Movement Control Orders (MCOs). Changes aimed to reduce patient flow and concentration at the on-site services locations, including less frequent in-person visits, increased use of telemedicine resources, and greater reliance on telecommunication methods to maintain contacts with patients and clients; changes in medication dispensing protocols, including increased take-home doses and relaxed rules for obtaining them, or delivery of medications to patients' homes or locations near their homes were reported by the majority of study participants. No significant rates of COVID-19 infections among PWUDs, including among those with HIV have been reported at the study sites. Conclusions: Although the reported changes presented new challenges for both services providers and recipients and resulted in some degree of initial disruption, generally, all participants reported successful implementation and high levels of compliance with the newly introduced restrictions, regulations, and protocols, resulting in relatively low rates of treatment disruption or discontinuation at the study sites.
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DOI：
10.1016/j.drugpo.2020.102958
发表时间：
2020-09
期刊：
The International journal on drug policy
影响因子：
--
作者：
Grebely J;Cerdá M;Rhodes T
通讯作者：
Rhodes T
影响因子：
4.4
作者：
Chang, Judy;Agliata, Jake;Guarinieri, Mauro
通讯作者：
Guarinieri, Mauro
影响因子：
4.4
作者：
Dunlop, Adrian;Lokuge, Buddhima;Maher, Lisa
通讯作者：
Maher, Lisa
影响因子：
4.7
作者：
Jemberie, Wossenseged Birhane;Stewart Williams, Jennifer;Lundgren, Lena M.
通讯作者：
Lundgren, Lena M.