减少与物质使用有关的危害:用于设计和评估减少危害的模拟优化框架 销售机器
Reyhaneh Zafarnejad1, Paul M Griffin2, Aleksandra E Zgierska3
1Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
概括
优化阿片类药物减少危害自动售货机 (HRVM) 用芬太尼试验条,纳洛和更安全的注射套件可以显著减少注射毒品 (PWID) 的人群中过量死亡和传染病的发生. 战略清单和成治疗联系增强了这些重要的公共卫生干预措施.
科学领域:
- 公共卫生 公共卫生
- 医疗信息学 医疗信息学
- 流行病学 流行病学
背景情况:
- 在注射药物使用者 (PWID) 中,过量死亡和传染病的增加需要创新的危害减少 (HR) 策略.
- 以阿片类药物为重点的降低伤害自动售货机 (HRVM) 提供了一个可扩展的解决方案,用于分发必需品,以减轻健康风险.
研究的目的:
- 开发和验证用于优化HRVM服务的模拟优化框架.
- 确定HRVM中的最佳产品配置,以尽量减少与阿片类药物相关的危害,包括过量服用和传染病.
主要方法:
- 开发并验证了一种基于代理的模拟优化框架.
- 该模型纳入了需求动态,补给,区域特征,并使用根据残疾调整的寿命年 (DALYs) 评估了健康结果.
- 基于场景的分析检查了HRVM配置的变化,芬太尼的患病率和减少危害物资的使用情况.
主要成果:
- 据估计,HRVM的最佳基线分配为48.5%的芬太尼试卷 (FTS),26.2%的纳洛和25.3%的安全注射套.
- 敏感性分析显示,最佳分配因芬太尼的流行率和FTS利用率而异,更高的FTS使用率有利于FTS分配.
- 增加成治疗转诊服务减少了DALY和成本,而更安全的注射套件也持续减少了血液感染.
结论:
- 模拟优化框架有助于HRVM服务规划和评估,强调战略库存管理.
- 人力资源管理系统 (HRVM) 是可扩展的,具有成本效益的人力资源干预措施,有可能对公共卫生产生重大影响.
- 整合HRVM与成护理服务对于提高健康结果和降低与物质使用相关的社会成本至关重要.
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