Alcohol Use Reduction in Methadone Individuals with HCV

丙型肝炎患者美沙酮饮酒减少

• 批准号: 7282731
• 负责人: Adeline M Nyamathi
• 金额: $ 17.81万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-01 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7282731
• 关键词: Absolute Alcohol; Address; Adult; Adverse effects; Alcohol consumption; Alcoholic beverage heavy drinker; Alcohols; Antidepressive Agents; Attitude; Behavior; Behavior Therapy; Behavioral; Blood; Caring; Categories; Centers for Disease Control and Prevention (U.S.); Chronic; Chronic Hepatitis; Cirrhosis; Client; Clinic; Combined Modality Therapy; Communities; Counseling; Daily; Data Aggregation; Disease; Drug Rehabilitation Centers; Drug usage; Effectiveness; Eligibility Determination; Enrollment; Equilibrium; Ethnic Origin; Evaluation; Female; Focus Groups; Free Will; Gender; Goals; HCV screening; Health; Health Promotion; Health Promotion and Education; Health Services; Health behavior; Health behavior change; Heavy Drinking; Hepatitis; Hepatitis A; Hepatitis A Virus; Hepatitis B Vaccines; Hepatitis B Virus; Hepatitis C virus; Heroin Users; Hour; Individual; Infection; Injection of therapeutic agent; Interferons; Intervention; Intervention Trial; Interview; Investigation; Knowledge; Liver; Liver Fibrosis; Maintenance; Malignant neoplasm of liver; Mediating; Medical; Methadone; Methods; Modeling; Numbers; Opiate Addiction; Opioid; Outcome; Outcome Study; Outpatients; Participant; Patient Self-Report; Patients; Perception; Persons; Pharmaceutical Preparations; Phase; Pilot Projects; Play; Population; Program Effectiveness; Provider; Randomized; Rate; Readiness; Recording of previous events; Research; Research Personnel; Risk Factors; Risk Reduction; Role; Screening procedure; Series; Services; Sex Behavior; Site; Social support; Staging; Standards of Weights and Measures; Subgroup; Symptoms; Target Populations; Testing; Time; United States National Institutes of Health; Vaccination; Virus Diseases; Visit; Week; alcohol abuse therapy; alcohol behavior; alcohol content; cognitive change; cost; drinking; eligible participant; experience; follow-up; improved; interest; motivational enhancement therapy; programs; research study; response; social; therapy design; treatment program; willingness

DESCRIPTION (provided by applicant): Nationwide, major strides have been made in treatment for HCV-infected patients using pegylated interferon and ribaviron; however use of these medications with HCV-infected opioid maintained (OM) IDUs in methadone maintenance (MM) treatment is problematic. Further, as many HCV-infected OM clients are continuing to drink alcohol, ongoing liver fibrosis and other social and behavioral consequences of alcohol use and abuse continue. Despite the fact that brief Motivational Interviewing (Ml) has demonstrated effectiveness, these programs are not conducted in MM treatment settings. Moreover, the effectiveness of group delivery, as opposed to one-on-one delivery, of Ml is unknown in terms of alcohol use reduction. In Phase I of this two-phased exploratory R21, a qualitative assessment will be conducted with 40 OM HCV-infected adults, 20 moderate alcohol users and 20 heavy alcohol users, equally divided by gender and readiness to change alcohol use, to explore with these clients: 1) factors impacting access to alcohol use reduction and health promotion services and free vaccination for HAV/HBV; and 2) strategies that MM staff can use to assist their clients in seeking services. Staff of a MM clinic will also explore the feasibility of providing these services. In Phase II, we plan to pilot an alcohol use reduction and liver health promotion intervention with 250 eligible, HCV-infected, alcohol-using OM clients receiving MM. Two intervention groups incorporating Ml) will provide on-site brief Ml (3 sessions) counseling to participants using either one-on-one delivery (Mi-Single) or the group-delivery (Mi-Group). In addition, each group will be offered the Liver Health Promotion (LHP) program, which includes a 30-minute health promotion education session, referral to a community 12-Step alcohol outpatient program, and an offer for free screening for HAV/HBV, and the HAV/HBV vaccination series, if eligible (defined as being HAV and/or HBV seronegative). All these services will be integrated within participants' usual MM clinic onsite services. A third group, the Usual Care (UC) group will receive the same components offered to the intervention groups except for a time balanced on-site brief 3 session health promotion counseling as opposed to the Ml. The short-term goals of the proposed study are to refine strategies that can be fully tested in a large-scale intervention trial. The long-term goals are to contribute to knowledge about promoting alcohol-related health-seeking and treatment completion behaviors in MM clinic settings that serve OM HCVpositive clients, so that population-specific intervention strategies can be developed.

描述(申请人提供)：在全国范围内，在使用聚乙二醇化干扰素和利巴韦隆治疗丙型肝炎病毒感染患者方面取得了重大进展；然而，将这些药物与丙型肝炎病毒感染的阿片类药物维持(OM)注射单位一起用于美沙酮维持(MM)治疗是有问题的。此外，随着许多感染了丙型肝炎病毒的OM患者继续饮酒，持续的肝纤维化和其他因饮酒和滥用而产生的社会和行为后果仍在继续。尽管简短的激励性访谈(ML)已经证明了有效性，但这些计划并不是在MM治疗环境中进行的。此外，在减少酒精使用方面，集体分娩与一对一分娩相比，ML的有效性尚不清楚。在这项分两个阶段进行的探索R21的第一阶段中，将对40名OM丙型肝炎感染者、20名中度酒精使用者和20名重度酒精使用者进行定性评估，按性别和改变饮酒意愿平均划分，以与这些客户探讨：1)影响获得减少酒精使用和健康促进服务以及免费接种甲型肝炎病毒/乙肝疫苗的因素；2)MM工作人员可以用来帮助他们的客户寻求服务的策略。多发性骨髓瘤诊所的工作人员也将探讨提供这些服务的可行性。在第二阶段，我们计划试行减少酒精使用和促进肝脏健康的干预措施，250名符合条件的、感染丙型肝炎病毒、使用酒精的OM患者接受MM治疗。两个包含ML的干预组将使用一对一分娩(Mi-Single)或集体分娩(Mi-Group)向参与者提供现场简短的ML(3次会议)咨询。此外，每一组都将接受肝脏健康促进(LHP)计划，其中包括30分钟的健康促进教育课程，转诊到社区12步酒精门诊计划，并提供免费HAV/乙肝筛查，如果符合条件(定义为HAV和/或HBV血清阴性)，还将提供HAV/乙肝疫苗系列接种。所有这些服务将被整合到参与者通常的MM诊所现场服务中。第三组，通常护理(UC)组将接受提供给干预组的相同组件，除了与ML相反的时间平衡的现场简要3次健康促进咨询。这项拟议研究的短期目标是改进可以在大规模干预试验中充分测试的策略。长期目标是促进在MM诊所环境中促进与酒精相关的健康寻求和治疗完成行为的知识，以便制定针对人群的干预策略。

项目成果

Perceptions of methadone maintained clients about barriers and facilitators to help-seeking behavior.

• DOI: 10.1353/cpr.2007.0032
• 发表时间: 2007-01-01
• 期刊: Progress in community health partnerships : research, education, and action
• 作者: Nyamathi, Adeline;Smith, Donna McNeese;de Castro, Viviane
• 通讯作者: de Castro, Viviane