Bridging the Gaps in Women's Primary Care for Those Treated at a Residential Drug Treatment Facility in Southwest Ohio

Anna Squibb, Bradley Subler, Tongfan Wu, Vijay K. Rings, Khadijah C. Collins
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Abstract

Background: Patients with substance use disorders (SUD) have higher rates of sexually transmitted infections (STI) and limited utility of preventive and outpatient primary care. Women with SUD are a particularly vulnerable population requiring consistent primary and reproductive health care. This study evaluated the need for providing women’s primary health care to patients in a residential SUD treatment facility in rural southwest Ohio.Methods: A retrospective chart review was conducted using intakes at a female-only residential SUD treatment facility from 2021-2022. Variables recorded in this study were: 1) patient-reported substance use; 2) laboratory screenings for hepatitis B, hepatitis C, HIV, and STIs; 3) reproductive history (contraceptive, Papanicolaou (Pap) test, and pregnancy history); 4) patient-reported connection with a primary care provider (PCP); and 5) patient-reported mental health disorders. The analysis provided descriptive statistics to identify comorbidities and trends in women with SUD.Results: All completed intake charts were reviewed (n=159) without exclusions. No current PCP was reported in 59% of patients. Papanicolaou tests were needed in 50% of patients, and, of those completed, six (21%) had abnormal results. Almost 20% of patients were found with a positive STI, with highest prevalence of trichomoniasis (23%). Viral infection rate was 42%, the most common being hepatitis C (35% with active infection). Patient-reported comorbid psychiatric illness was 90%, the most common being generalized anxiety disorder (GAD) at 67.3%.Conclusion: This study supports the need for whole person primary care in residential SUD treatment facilities, particularly in respect to viral and sexually transmitted infections, and for overall women's health.
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弥合妇女在俄亥俄州西南部一个住院药物治疗机构接受治疗的初级保健差距
背景:物质使用障碍(SUD)患者的性传播感染(STI)发生率较高,预防性和门诊初级保健的效用有限。患有SUD的妇女是特别脆弱的群体,需要持续的初级保健和生殖保健。本研究评估了为俄亥俄州西南部农村地区的住院治疗机构的患者提供妇女初级卫生保健的必要性。方法:对2021-2022年在一家仅限女性居住的SUD治疗设施的入院患者进行回顾性图表回顾。本研究记录的变量有:1)患者报告的药物使用情况;2)乙型肝炎、丙型肝炎、艾滋病毒和性传播感染的实验室筛查;3)生殖史(避孕、巴氏试验、妊娠史);4)患者报告的与初级保健提供者的联系(PCP);5)患者报告的精神健康障碍。该分析提供了描述性统计数据,以确定女性SUD的合并症和趋势。结果:回顾了所有完成的入院表(n=159),没有排除。59%的患者无PCP报告。50%的患者需要进行帕帕尼科拉氏试验,在完成试验的患者中,有6例(21%)结果异常。近20%的患者发现性传播感染呈阳性,其中滴虫病患病率最高(23%)。病毒感染率为42%,最常见的是丙型肝炎(35%为活动性感染)。患者报告的共病精神疾病占90%,最常见的是广泛性焦虑症(GAD),占67.3%。结论:本研究支持在住宅性性功能障碍治疗机构中进行全人初级保健的必要性,特别是在病毒和性传播感染方面,以及对妇女的整体健康。
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