Reduction of Medical Complications associated with Injection Drug Use

减少与注射药物使用相关的医疗并发症

• 批准号: 7685140
• 负责人: Kristina T. Phillips
• 金额: $ 19.83万
• 依托单位: UNIVERSITY OF NORTHERN COLORADO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-06-15 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7685140
• 关键词: Abstinence; Accident and Emergency department; Admission activity; Area; Bacterial Infections; Behavioral; Belief; Blood; Counseling; Drug abuse; Drug usage; Endocarditis; Feedback; Focus Groups; Frequencies; Future; Goals; Group Interviews; HIV; Health; Health Care Costs; Hepatitis; Hepatitis C; Hepatitis C virus; Hospitalization; Hospitals; Hygiene; Infection; Infection Control; Infection prevention; Injecting drug user; Injection of therapeutic agent; Intervention; Intramuscular Injections; Language; Lead; Measures; Medical; Morbidity - disease rate; Motivation; Needles; Outcome; Overdose; Participant; Patient Self-Report; Pharmaceutical Preparations; Phase; Pilot Projects; Policy Maker; Population; Prevalence; Prevention program; Procedures; Public Health; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Recruitment Activity; Relapse; Reporting; Research; Risk; Risk Assessment; Skin; Staging; Testing; Theoretical model; TimeLine; Treatment Efficacy; Upper arm; Viral; Virus Diseases; Visit; base; cost; design; effective intervention; high risk; improved; medical complication; meetings; motivational enhancement therapy; programs; psychoeducation; psychologic; public health relevance; skills; skills training; skin abscess; social; subcutaneous; therapy design; therapy development

DESCRIPTION (provided by applicant): Injection drug use (IDU) is a major public health problem that is associated with a host of medical complications, including blood-borne viral disease (e.g., HIV, Hepatitis C) and bacterial infections (e.g., skin abscesses, endocarditis), that often result from high-risk drug injection practices. There are no current interventions designed to reduce bacterial infections among IDUs, despite approximately 32% of IDUs reporting a current infection and almost 70% reporting a lifetime prevalence. The long-term objective of this program of research is to reduce high-risk injection practices among active IDUs that lead to bacterial and viral infections by developing and establishing the efficacy of an intervention that combines psychoeducation, skill-building, and motivational interviewing. In the first phase of the study, we will conduct focus group interviews with 16 IDUs in order to determine key areas of emphasis for an intervention with this population. We will then develop an infection-control intervention for active IDUs, pilot the intervention with 5 new participants in an open trial, and elicit their feedback regarding the intervention. Following refinement of the intervention, we will conduct a small randomized controlled trial (n = 60; 30 in each arm) to examine the efficacy of the intervention compared to an assessment-only condition. We expect that participants randomized to the intervention will improve skin and needle cleaning behavioral skills and reduce high-risk injection practices for bacterial and viral infections. In addition, we will examine the acceptability and feasibility of the intervention to participants at all phases. This intervention will help to reduce the acquisition of bacterial infections and viral disease among IDUs, thus improving health outcomes for this population and reducing health care costs. PUBLIC HEALTH RELEVANCE: Viral and bacterial infections are a major problem among injection drug users, and contribute to costly emergency department utilization, hospitalization, and morbidity. The goal of this Stage I treatment development project is to develop and test the initial feasibility, acceptability, and efficacy of a skin and needle hygiene intervention for IDUs. The long-term objective of this program of research is to develop effective infection prevention programs that incorporate components of the Information-Motivation-Behavioral Skills theoretical model.

描述（由申请人提供）：注射吸毒（IDU）是一个主要的公共卫生问题，与许多医疗并发症有关，包括血源性病毒性疾病（例如，HIV、丙型肝炎）和细菌感染（例如，皮肤脓肿、心内膜炎），这通常是由高风险药物注射操作引起的。尽管大约32%的注射吸毒者报告当前感染，近70%的注射吸毒者报告一生患病率，但目前还没有旨在减少注射吸毒者细菌感染的干预措施。这项研究计划的长期目标是通过开发和建立一种结合心理教育、技能培养和动机访谈的干预措施的有效性，减少活跃的注射吸毒者中导致细菌和病毒感染的高风险注射做法。在研究的第一阶段，我们将与16名注射吸毒者进行焦点小组访谈，以确定对这一人群进行干预的重点领域。然后，我们将为活跃的注射吸毒者开发一种感染控制干预措施，在一项开放试验中对5名新参与者进行干预，并征求他们对干预措施的反馈。在完善干预措施后，我们将进行一项小型随机对照试验（n = 60;每组30例），以检查干预措施与仅评估条件相比的疗效。我们希望随机分配到干预组的参与者将改善皮肤和针头清洁行为技能，并减少细菌和病毒感染的高风险注射实践。此外，我们亦会研究介入对各阶段参与者的接受程度及可行性。这一干预措施将有助于减少注射吸毒者中细菌感染和病毒性疾病的发生，从而改善这一人群的健康状况并降低保健费用。公共卫生相关性：病毒和细菌感染是注射吸毒者的主要问题，并导致昂贵的急诊室使用，住院治疗和发病率。第一阶段治疗开发项目的目标是开发和测试注射吸毒者皮肤和针头卫生干预的初步可行性、可接受性和有效性。该研究计划的长期目标是制定有效的感染预防计划，其中包括信息-动机-行为技能理论模型的组成部分。