肯塔基州的型肝炎C治疗 医疗补助受理者与同时使用阿片类药物使用障碍:一个跨部门研究
Olivia K Sugarman1, Brendan Saloner2, Samantha J Harris2
1Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. osugarm1@jh.edu.
接受药物治疗阿片类药物使用障碍 (MOUD) 的阿片类药物使用障碍 (OUD) 患者不太可能接受治愈性C型肝炎病毒 (HCV) 治疗. 这突显了肯塔基州对HCV和OUD的联合治疗的差距.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 成 药物 药物 药物 药物
背景情况:
- 与此同时,C型肝炎病毒 (HCV) 感染和注射药物的使用也在增加.
- 同时治疗慢性HCV和阿片类药物使用障碍 (OUD) 的药物支持有证据.
- 肯塔基州面临着HCV和OUD的重大挑战,促使政策和实践改变以改善药物获取.
研究的目的:
- 为了检查接收的直接作用抗病毒药物 (DAA) 对于同时感染HCV和OUD的患者.
- 为了比较那些接受任何阿片类药物使用障碍 (MOUD) 药物治疗的患者与没有MOUD的患者之间的DAA接收.
主要方法:
- 一项横截面研究利用了HealthVerity专有的健康声明数据集,从2020年1月1日至2021年12月31日.
- 该研究包括18岁及以上的肯塔基州医疗补助受益者,同时患有慢性HCV和OUD诊断.
- 采用多变量后勤回归模型来评估基于MOUD状态的HCV DAA接收的调整比例.
主要成果:
- 在2149名患者中,36%接受了HCVDAA,84%接受了MOUD.
- 布普伦诺芬是最常用的MOUD (66%).
- 接受任何MOUD的患者接受HCVDAA的可能性较小 (33%对46%,p < 0.0001),其中甲显示出最大的差异 (29%对46%,p = 0.0002).
结论:
- 肯塔基州的医疗补助接受者在OUD的HCV治疗中存在显著的差距.
- 尽管有证据支持联合治疗,但接受MOUD的患者获得治愈性HCV治疗的可能性明显低.
- 这些发现强调需要改善对同时出现HCV和OUD的个体的综合护理.
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