Pilot Study of a Community-Pharmacy Model to Expand Access to Medications to Treat and Prevent Hepatitis C, Opioid Use Disorders, Overdose and HIV Among Persons Who Inject Drugs

社区药房模式试点研究，以扩大注射吸毒者获得治疗和预防丙型肝炎、阿片类药物使用障碍、药物过量和艾滋病毒的药物的机会

基本信息

批准号：
10197864
负责人：
Judith Tsui
金额：
$ 21.46万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-08-01 至 2023-06-30
项目状态：
已结题

项目摘要

ABSTRACT/PROJECT SUMMARY The opioid epidemic is a major public health crisis in the United States, leading to substantial morbidity and mortality related to the consequences of opioid use disorders and injection drug use, namely hepatitis C virus (HCV), HIV, and overdose. Yet, we are at a unique historical moment, as we possess effective medications that can improve and sustain the lives of people who inject drugs (PWID). Currently there are medications that can be prescribed to 1) cure HCV (directly-acting antivirals or DAAs), 2) prevent HIV infection (Pre-exposure Prophylaxis [PrEP]), and 3) treat/prevent overdose (naloxone and medications to treat OUD). Furthermore, there is an unprecedented opportunity to eliminate HCV, a disease that is transmitted through injecting drugs. However, achieving the goals of elimination will require better systems for allowing PWID access to medications to cure hepatitis C, as well as medications to prevent overdose and HIV. Pharmacists and community-pharmacy programs may be an innovative solution for this problem. Collaborative Drug Therapy Agreements (CDTAs) allow pharmacists to have authority to autonomously perform testing and prescribing and dispensing medications. We propose to use this R34 mechanism to develop and pilot test a novel health service delivery model, namely a community-pharmacy program for providing DAAs and medications to prevent overdose and HIV among PWID with HCV. For Aim #1, we will conduct qualitative interviews with PWID with HCV and other key community stakeholders in order to inform the development of a community- pharmacy program to expand access to medications to treat HCV and prevent overdose and HIV. For Aim #2, we will pilot and evaluate the community-pharmacy program at a local pharmacy in Seattle. This application is submitted under the funding announcement PA-18-774 (“Pilot Health Services and Economic Research on the Treatment of Drug, Alcohol, and Tobacco Abuse”), which includes pilot testing of health service interventions that optimize access utilization of drug use disorder related services, as well as services for comorbid medical conditions. The proposed research leverages a number of existing community partnerships with local stakeholders and would lead to a future multi-site effectiveness study that would utilize existing community- based pharmacies in order to work toward improving drug users' health by expanding access to life-saving medications.

摘要/项目摘要阿片类药物流行是美国的一场重大公共卫生危机，导致大量发病率和与阿片类药物使用障碍和注射毒品（即丙型肝炎病毒）后果相关的死亡率（丙型肝炎病毒）、艾滋病毒和过量用药然而，我们正处于一个独特的历史时刻，因为我们拥有有效的药物。可以改善和维持注射吸毒者 (PWID) 的生活目前有一些药物可以改善和维持注射吸毒者的生活。可用于 1) 治愈 HCV（直接作用抗病毒药物或 DAA），2) 预防 HIV 感染（暴露前预防 [PrEP])，以及 3) 治疗/预防用药过量（纳洛酮和治疗 OUD 的药物）。现在有一个前所未有的机会消除丙型肝炎病毒（一种通过注射毒品传播的疾病）。然而，实现消除目标将需要更好的系统来允许注射吸毒者接触到治疗丙型肝炎的药物，以及预防用药过量和艾滋病毒的药物。社区药房计划可能是解决这一问题的创新解决方案。协议 (CDTA) 允许药剂师有权自主执行测试和处方，我们建议使用这种 R34 机制来开发和试点测试一种新型健康药物。服务提供模式，即社区药房计划，为患者提供 DAA 和药物预防丙型肝炎吸毒者吸毒过量和感染艾滋病毒对于目标#1，我们将进行定性访谈。 PWID 与 HCV 和其他主要社区利益相关者一起，以便为社区的发展提供信息- 药房计划旨在扩大治疗丙肝病毒并预防用药过量和艾滋病毒的药物获取范围，实现目标#2。我们将在西雅图当地的一家药房试点并评估社区药房计划。根据资助公告 PA-18-774（“试点健康服务和经济研究”）提交药物、酒精和烟草滥用的治疗”），其中包括对卫生服务干预措施的试点测试优化吸毒障碍相关服务以及共病医疗服务的获取利用拟议的研究利用了一些现有的社区与当地的合作伙伴关系。利益相关者，并将导致未来的多地点有效性研究，该研究将利用现有的社区药房，以通过扩大获得救生药物的机会来努力改善吸毒者的健康药物。

项目成果

期刊论文数量（4）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Barriers and facilitators to implementing a Pharmacist, Physician, and Patient Navigator-Collaborative Care Model (PPP-CCM) to treat hepatitis C among people who inject drugs.

在注射吸毒者中实施药剂师、医生和患者导航员协作护理模式 (PPP-CCM) 来治疗丙型肝炎的障碍和促进因素。

DOI：
发表时间：
2023-01
期刊：
影响因子：
0
作者：
Austin, Elizabeth J;Gojic, Alexander J;Bhatraju, Elenore P;Pierce, Kathleen A;Pickering, Eleanor I;Tung, Elyse L;Scott, John D;Hansen, Ryan N;Glick, Sara N;Stekler, Joanne D;Connolly, Nancy C;Villafuerte, Sarah;McPadden, Madison;Deutsch, Sara
通讯作者：
Deutsch, Sara

Health care-seeking experiences for people who inject drugs with hepatitis C: Qualitative explorations of stigma.

丙型肝炎注射吸毒者的就医经历：耻辱的定性探索。

DOI：
发表时间：
2022-06
期刊：
影响因子：
3.9
作者：
Austin, Elizabeth J.;Tsui, Judith, I;Barry, Michael P.;Tung, Elyse;Glick, Sara N.;Ninburg, Michael;Williams, Emily C.
通讯作者：
Williams, Emily C.

Pilot study of a community pharmacist led program to treat hepatitis C virus among people who inject drugs.

社区药剂师领导的一项针对注射吸毒者治疗丙型肝炎病毒的试点研究。

DOI：
发表时间：
2024-03
期刊：
影响因子：
0
作者：
Tsui, J I;Gojic, A J;Pierce, K A;Tung, E L;Connolly, N C;Radick, A C;Hunt, R R;Sandvold, R;Taber, K;Ninburg, M;Kubiniec, R H;Scott, J D;Hansen, R N;Stekler, J D;Austin, E J;Williams, E C;Glick, S N
通讯作者：
Glick, S N

Qualitative inquiry into perceptions of HIV pre-exposure prophylaxis among people who inject drugs living with hepatitis C in Seattle, WA, USA.

对美国华盛顿州西雅图注射吸毒丙型肝炎患者对艾滋病毒暴露前预防的看法进行定性调查。

DOI：
发表时间：
2022-11-01
期刊：
影响因子：
4.4
作者：
Barry, Michael P.;Austin, Elizabeth J.;Bhatraju, Elenore P.;Glick, Sara N.;Stekler, Joanne D.;Tung, Elyse L.;Hansen, Ryan N.;Williams, Emily C.;Gojic, Alexander J.;Pickering, Eleanor, I;Tsui, Judith, I
通讯作者：
Tsui, Judith, I