High HCV cure rates among people who inject drugs and have suboptimal adherence: A patient-centered approach to HCV models of care.
High HCV cure rates among people who inject drugs and have suboptimal adherence: A patient-centered approach to HCV models of care.
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DOI：
10.1016/j.drugpo.2021.103135
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Litwin AH
中科院分区：
文献类型：
--
作者：
Norton BL;Akiyama MJ;Arnsten JH;Agyemang L;Heo M;Litwin AH
虽然注射毒品（PWID）的人占丙型肝炎病毒（HCV）流行病的大多数，但对坚持的担忧往往使PWID无法接受直接作用的抗病毒（DAA）药物。最有效的HCV治疗模式，以促进持续病毒学应答（SVR）和高依从性需要进行评估。我们在纽约布朗克斯的三个阿片类药物治疗项目（OTP）中进行了一项前瞻性队列研究。参与者与提供者合作，选择三种现场护理模式之一：直接观察治疗（mDOT），团体治疗（GT）或自我管理的个体治疗（SIT）。比较两组之间的SVR 12、每日依从性和参与者特征。在61名参与者中，大多数是男性（62%）和拉丁美洲人（67%），平均年龄为53岁（SD 9）。参与者通过三种护理模式之一接受DAA：mDOT（21%），GT（25%）或SIT（54%）。大多数人（59%）在治疗期间使用非法药物。总体而言，SVR 12为98%，治疗模式之间无差异：mDOT（100%）、GT（100%）和SIT（97%）（p = 1.0）。总体而言，每日依从性为73%（SD 16）;选择mDOT的患者为86%，而选择GT的患者为71%（p < 0.01），选择SIT的患者为73%（p < 0.01）。尽管持续使用非法药物和次优依从性，SVR 12在使用三种护理模式中的任何一种的OTP现场治疗的PWID中很高。在真实的世界环境中共同决策可能是选择适当的PWID护理模式的关键。
Though people who inject drugs (PWID) make up the majority of the hepatitis C virus (HCV) epidemic, concerns about adherence often exclude PWID from receiving direct-acting antiviral (DAA) medication. The most effective models of HCV care to promote sustained virologic response (SVR) and high adherence need to be evaluated. We conducted a prospective cohort study in three opioid treatment programs (OTPs) in the Bronx, NY. Participants, in collaboration with providers, chose one of three models of onsite care: directly observed therapy (mDOT), group treatment (GT), or self-administered individual treatment (SIT). SVR12, daily adherence, and participant characteristics were compared between groups. Of 61 participants, the majority were male (62%) and Latino (67%), with a mean age of 53 (SD 9). Participants received DAAs via one of three models of care: mDOT (21%), GT (25%), or SIT (54%). The majority (59%) used illicit drugs during treatment. Overall, SVR12 was 98% with no differences between models of care: mDOT (100%), GT (100%), and SIT (97%) (p = 1.0). Overall, daily adherence was 73% (SD 16); 86% among those who chose mDOT compared to 71% among those who chose GT (p < 0.01) and 73% among those who chose SIT (p < 0.01). Despite ongoing illicit drug use and suboptimal adherence, SVR12 was high among PWID treated onsite at an OTP using any one of three models of care. Shared decision making in real world settings may be key to choosing the appropriate model of care for PWID.
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DOI：
10.1111/add.14393
发表时间：
2019-01
期刊：
Addiction (Abingdon, England)
影响因子：
--
作者：
Grebely J;Larney S;Peacock A;Colledge S;Leung J;Hickman M;Vickerman P;Blach S;Cunningham EB;Dumchev K;Lynskey M;Stone J;Trickey A;Razavi H;Mattick RP;Farrell M;Dore GJ;Degenhardt L
通讯作者：
Degenhardt L
影响因子：
158.5
作者：
Alter, MJ;Kruszon-Moran, D;Margolis, HS
通讯作者：
Margolis, HS
影响因子：
39.2
作者：
Dore, Gregory J.;Altice, Frederick;Platt, Heather L.
通讯作者：
Platt, Heather L.
影响因子：
4.4
作者：
Grebely, Jason;Genoway, Krista;Conwaya, Brian
通讯作者：
Conwaya, Brian
影响因子：
2
作者：
Asher AK;Portillo CJ;Cooper BA;Dawson-Rose C;Vlahov D;Page KA
通讯作者：
Page KA