Abstract:
BACKGROUND:People who inject drugs (PWID) are disproportionally affected by the hepatitis C virus (HCV) infection. In the Netherlands, active HCV transmission in PWID has practically been halted but uptake of HCV testing and linkage to care remains insufficient in this risk group. A national HCV in Addiction Care (HAC) quality improvement project based on the Breakthrough methodology (i.e. Breakthrough project) aimed to secure proper linkage to care in PWID by introducing local HCV healthcare screening and treatment pathways in addiction care units. AIM:To qualitatively appraise the local HCV healthcare pathways; to evaluate the yield in terms of number of PWID screened, diagnosed, referred, and treated; and to identify best practices and barriers to successful participation in the HAC Breakthrough project. METHODS:Between 2013 and 2016, 12 units of addiction care centers throughout the Netherlands participated in two series of a HAC Breakthrough project. Local multidisciplinary teams created HCV healthcare pathways. Quality assessment of HCV healthcare pathways was performed retrospectively and data on screening results was collected. In-depth interviews were conducted to elucidate best practices and essential elements for successful participation. RESULTS:In total, six HCV healthcare pathways were submitted by ten teams of which 83% was judged to be of "good" or "sufficient" quality. Uptake of HCV-antibody screening was 40% (N = 487/1219) and uptake of HCV-RNA in HCV-antibody positives was 59% (N = 107/181). The project resulted in 76 (6%) newly detected cases of persistent HCV viremia. Of all HCV-RNA positives, 92% was referred to a hepatitis treatment center. In 39% (N = 27/70) of those referred, treatment initiation was documented and 82% (N = 22/27) achieved a sustained virological response. Teams identified several best practices including motivational counseling training, oral swabs for anti-HCV testing, facilitating complementary HCV RNA testing, and supervised hospital visits. CONCLUSION:The HAC Breakthrough project has brought about good quality HCV healthcare pathways in the majority of participating addiction care centers and has successfully linked PWID with ongoing HCV viremia to care. Uptake of HCV screening and treatment after referral were identified as the main gaps to be closed in the HCV cascade of care to achieve final HCV elimination in Dutch PWID (i.e. micro-elimination).
journal_name
Harm Reduct Jjournal_title
Harm reduction journalauthors
Kracht PAM,de Gee EA,van der Poel A,Verhagen MAMT,Hoepelman AIM,Croes EA,Arends JEdoi
10.1186/s12954-019-0316-4subject
Has Abstractpub_date
2019-07-15 00:00:00pages
45issue
1issn
1477-7517pii
10.1186/s12954-019-0316-4journal_volume
16pub_type
杂志文章abstract:BACKGROUND:Stigma and discrimination may adversely affect the benefits of methadone maintenance treatment (MMT) for drug users, especially in disadvantaged settings. This study assessed stigma and discrimination against MMT patients in the mountainous and rural areas in Vietnam and explored their associated factors to ...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-016-0127-9
更新日期:2017-01-06 00:00:00
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journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-1-8
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journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-5-19
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journal_title:Harm reduction journal
pub_type: 杂志文章,多中心研究
doi:10.1186/s12954-018-0269-z
更新日期:2018-12-11 00:00:00
abstract:BACKGROUND:This study aimed to investigate the development of opioid tolerance in patients receiving long-term methadone maintenance treatment (MMT). METHODS:A region-wide cross-sectional study was performed focusing on dosage and duration of treatment. Differences between racemic methadone and levomethadone were exam...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-016-0095-0
更新日期:2016-02-16 00:00:00
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journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-10-28
更新日期:2013-10-31 00:00:00
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journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-2-5
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abstract:BACKGROUND:New, more effective and better-tolerated therapies for hepatitis C (HCV) have made the elimination of HCV a feasible objective. However, for this to be achieved, it is necessary to have a detailed understanding of HCV epidemiology in people who inject drugs (PWID). Respondent-driven sampling (RDS) can provid...
journal_title:Harm reduction journal
pub_type: 杂志文章,meta分析,评审
doi:10.1186/s12954-017-0172-z
更新日期:2017-07-11 00:00:00
abstract:BACKGROUND:Illicit drug users have a high prevalence of HCV and represent the majority of newly infected persons in the U.S. Despite the availability of effective HCV treatment, few drug users have been evaluated or treated for HCV. Racial and ethnic minorities have a higher incidence and prevalence of HCV and higher H...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-10-10
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journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-10-23
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journal_title:Harm reduction journal
pub_type: 社论
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1186/1477-7517-9-7
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pub_type: 杂志文章
doi:10.1186/s12954-020-00367-2
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pub_type: 杂志文章
doi:10.1186/s12954-015-0085-7
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doi:10.1186/s12954-020-00394-z
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journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-4-20
更新日期:2007-12-08 00:00:00
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pub_type: 杂志文章
doi:10.1186/1477-7517-2-17
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pub_type: 杂志文章
doi:10.1186/s12954-020-00377-0
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pub_type: 杂志文章
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journal_title:Harm reduction journal
pub_type: 杂志文章,meta分析
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更新日期:2018-05-09 00:00:00
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pub_type: 杂志文章
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journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-1-7
更新日期:2004-06-01 00:00:00
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pub_type: 杂志文章
doi:10.1186/1477-7517-7-11
更新日期:2010-05-25 00:00:00
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journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-8-8
更新日期:2011-04-17 00:00:00
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journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-020-00373-4
更新日期:2020-05-12 00:00:00
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pub_type: 杂志文章
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更新日期:2020-11-17 00:00:00
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journal_title:Harm reduction journal
pub_type: 杂志文章
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