Comprehensive Care for People Who Use Drugs: Combining Infectious Diseases Services, Harm Reduction, and Primary Care

Area of Science:

• Public Health
• Infectious Diseases
• Substance Use Disorders

Background:

• People who use drugs (PWUD) face significant barriers to primary care and have increased infectious disease risks.
• Community-based harm reduction (HR) programs are vital, trusted sources of care for PWUD.
• Expanding services within HR programs can enhance access and engagement for this population.

Purpose of the Study:

• To assess the uptake of comprehensive health services within a pilot harm reduction program in Chicago.
• To evaluate the integration of primary care, infectious diseases consultation, and substance use disorder (SUD) services.
• To understand healthcare utilization patterns among PWUD receiving integrated care.

Main Methods:

• PWUD were referred to embedded primary care and infectious diseases providers within an HR program.
• Clinical encounters from October 2018 to December 2021 were reviewed.
• Patient demographics, visit types, and SUD status were analyzed and compared.

Main Results:

• The pilot program served 552 unique patients across 1720 clinical encounters.
• The majority of patients were male (70.7%) with a median age of 43; 75.2% had public insurance.
• Active SUD care comprised 71.3% of encounters, with nearly a quarter addressing infections like Hepatitis C and HIV.

Conclusions:

• Integrating primary care and infectious diseases services in community-based HR programs leads to high healthcare utilization by PWUD.
• This comprehensive care model effectively addresses the specific needs of PWUD.
• The integrated approach mitigates common barriers to healthcare access for this population.