Addiction Medicine Physicians and Care for Hepatitis C

描述(由申请人提供)： 吸毒者受到丙型肝炎的严重和不成比例的影响，但他们在医疗保健方面面临着许多障碍，这使他们面临着获得比非吸毒者低得多的丙型肝炎护理水平的风险。由于他们与个别吸毒者的持续接触，以及他们对复杂的医疗保健的了解和经验，从事成瘾治疗的医生在促进吸毒者获得丙型肝炎治疗并取得成功方面处于独特的地位。然而，目前还没有数据来描述成瘾医学医生对丙型肝炎药物使用者的护理知识、态度和经验。我们建议在全国范围内对美国成瘾医学会(ASAM)的800多名医生成员进行调查。纽约州在美沙酮维持治疗计划中行医的非ASAM医生也将接受调查，并与ASAM成员进行比较，以确定从后者队列得出的结果的普适性。拟议的研究将涉及以下具体目标： 目的1：描述成瘾医学医生对丙型肝炎治疗合格指南的了解和态度，并确定这些态度与医生直接或通过转诊提供丙型肝炎治疗的相关性； 目的2：确定成瘾医学医生提供的艾滋病毒治疗与向DU提供丙型肝炎治疗之间的联系，无论是直接治疗还是转诊； 目的3：确定药物治疗计划中的现场初级医疗服务的可获得性与成瘾医学医生直接或转介向DU提供丙型肝炎治疗之间的关联。 这项调查将重点调查医生对治疗资格标准的了解和态度，如戒毒戒酒时间和抑郁史。它将询问医生关于他们通过转介或自己直接管理的方式为吸毒者治疗丙型肝炎的经验，以及他们获得治疗资源的情况。它还将询问他们的临床实践设置和专业背景。 这项拟议的研究将确定成瘾药物医生向吸毒者提供丙型肝炎保健服务的优势和劣势，并将重点收集有助于制定旨在改善吸毒者获得丙型肝炎治疗的干预措施的数据。这项研究的数据将与药物滥用治疗政策和临床实践相关。

DESCRIPTION (provided by applicant): Drug users are heavily and disproportionately affected by hepatitis C, yet they face numerous barriers to healthcare that place them at risk for substantially lower levels of hepatitis C care than non-drug users. Because of their continuous contact with individual drug users and their knowledge of and experience with the intricacies of their healthcare, physicians practicing addiction medicine are in a unique position to facilitate drug users' access to and success with hepatitis C treatment. However, no data exists to describe the knowledge, attitudes and experience of addiction medicine physicians regarding hepatitis C care for drug users. We propose to nationwide survey of over 800 physician members of the American Society of Addiction Medicine (ASAM). Non-ASAM physicians practicing medicine in methadone maintenance treatment programs New York State will also be surveyed and compared to ASAM members to determine the generalizability of findings derived from the latter cohort. The proposed study will address the following specific aims: Aim 1: To describe the knowledge of and attitudes towards eligibility guidelines for hepatitis C treatment among physicians in addiction medicine, and determine the association between these attitudes and the physicians' provision of hepatitis C treatment to DUs, either direct or by referral; Aim 2: To determine the association between provision of HIV care by physicians in addiction medicine and the provision of hepatitis C treatment to DUs, either direct or by referral; Aim 3: To determine the association between the availability of onsite primary medical care in drug treatment programs and provision of hepatitis C treatment to DUs, either direct or by referral, by physicians in addiction medicine. The survey will focus on physicians' knowledge and attitudes surrounding treatment eligibility criteria, such as duration of abstinence from drug and alcohol use and history of depression. It will query physicians about their experience with hepatitis C treatment for drug users, either by referral or by direct management themselves, and their access to treatment resources. It will also inquire about their clinical practice setting and their professional background. The proposed study will identify strengths and weaknesses in the delivery of hepatitis C healthcare by addiction medicine physicians to drug users, and it will focus on collecting data useful for the development of interventions designed to improve drug users' access to hepatitis C treatment. Data from this study will have relevance to both drug abuse treatment policy and clinical practice.