在一个屋檐下-药物使用障碍和病毒性肝炎/艾滋病毒治疗的综合诊所

Sarah Hipkens, E. Caron, W. Craig, K. Thakarar
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摘要

病毒性肝炎/艾滋病毒护理和物质使用障碍(SUD)治疗的整合已被证明可以改善患者的预后,但在缅因州等农村州缺乏相关数据。我们的研究目的是评估在我们农村州最近建立的“桥梁计划”中接受药物使用和病毒性肝炎/艾滋病联合治疗的SUD患者的基线特征和结果。方法:我们对2020年1月至2021年11月期间参加桥梁计划的患者进行了回顾性图表回顾。然后,我们对人口统计学、健康特征、预防服务和治疗结果进行了描述性分析。结果:桥梁项目共纳入14例患者,其中13/14(93%)患有丙型肝炎,3/14(21%)患有艾滋病毒。当有指示时,100%的参与者接受适当的药物成瘾治疗(丁丙诺啡/纳洛酮或纳曲酮),纳洛酮试剂盒和甲型肝炎和乙型肝炎疫苗接种。在丙型肝炎患者中,12/13(92%)开始抗病毒治疗,其中10/12(83%)获得治疗治愈或正在接受持续治疗。讨论:综合护理模式可以成功地将SUD和HIV/病毒性肝炎作为共同发生的疾病进行治疗。这些模型必须考虑减少最佳治疗所需的就诊次数和旅行时间的方法,并通过持续开具循证治疗SUD的药物来提高康复。结论:我们的研究表明,农村地区的综合诊所模式可以提供全面的护理,包括SUD治疗、纳洛酮处方、疫苗接种,以及更重要的是,丙型肝炎/艾滋病毒治疗成功率高。
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Under One Roof – An Integrated Clinic for Substance Use Disorder and Viral Hepatitis/HIV Treatment
Introduction: Integration of viral hepatitis/HIV care and substance use disorder (SUD) treatment has been shown to improve patient outcomes, but data are lacking in rural states like Maine. Our study objective was to assess the baseline characteristics and outcomes of patients with SUD who receive combined substance use and viral hepatitis/HIV treatment at a recently established “Bridge Program” in our rural state. Methods: We conducted a retrospective chart review of patients enrolled in the Bridge Program between January 2020 and November 2021. We then performed a descriptive analysis of demographics, health characteristics, preventive services, and treatment outcomes. Results: A total of 14 patients were enrolled in the Bridge Program, of which 13/14 (93%) had hepatitis C, and 3/14 (21%) had HIV. When indicated, 100% of participants received appropriate medication for addiction treatment (buprenorphine/naloxone or naltrexone), naloxone kits, and hepatitis A and B vaccinations. Among patients with hepatitis C, 12/13 (92%) started antiviral treatment, of which 10/12 (83%) either achieved treatment cure or are receiving ongoing treatment. Discussion: Integrated care models can successfully treat SUD and HIV/viral hepatitis as co-occurring medical conditions. These models must consider approaches to reduce the number of visits and travel time required for optimal treatment, and enhance recovery by consistently prescribing evidence-based medication for SUD. Conclusions: Our study shows how an integrated clinic model in a rural state can provide comprehensive care, including SUD treatment, naloxone prescribing, vaccinations, and, importantly, high rates of successful hepatitis C/HIV treatment.
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