A pre-post study of the impact of a multidisciplinary model of care on linkage to hepatitis C care following release from prison: The Beyond Prison Walls study

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy Pub Date : 2025-06-11 DOI:10.1016/j.drugpo.2025.104873

Nadine Kronfli , Andrea Mambro , Allen O’Brien , Camille Dussault , Sylvie Chalifoux , Lina del Balso , Apostolia Petropoulos , Mona Lim , Alexandros Halavrezos , Bertrand Lebouche , Giada Sebastiani , Marina B. Klein , Joseph Cox

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引用次数: 0

Abstract

Background

Many people are released from prison with untreated hepatitis C virus (HCV) and fail to link to care due to competing priorities. We compared linkage to HCV care among individuals who engaged in a multidisciplinary model of care versus in standard of care, and examined factors associated with linkage to care.

Methods

We conducted a prospective, quasi-experimental pre-post study in Quebec’s largest provincial prison. Participants in the intervention arm met with a nurse, social worker, and patient navigator and were offered appointment accompaniment post-release. Participants in the control arm received a pre-release discharge appointment. The primary outcome was linkage to HCV care, defined as a documented visit with an HCV care provider within 90 days of release. Bayesian logistic regression was used to determine the impact of the intervention on linkage and to analyze relationships between covariates of interest and linkage. Probability differences and 95 % credible intervals (95 % CrI) were calculated.

Results

Overall, 648 participants underwent HCV screening; 19 and 20 had current HCV infection in the control and intervention arms, respectively. Among these, 2 (11 %) and 14 (80 %) were linked to care post-release, respectively. Intervention participants had a + 70 % (45 %, 88 %) difference in linkage to care versus control participants. Among intervention participants, those who were successfully contacted post-release were more likely to be linked to care [+64 % (14 %, 90 %)] than those who were not.

Conclusions

A multidisciplinary model of care increased linkage to HCV care among untreated individuals released from prison. Future interventions should support similar models, leveraging social support networks to maximize continuity of care.

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多学科护理模式对出狱后丙型肝炎护理联系的影响的前后研究：超越监狱墙研究

背景：许多人出狱时携带未经治疗的丙型肝炎病毒（HCV），由于优先事项相互竞争而未能获得治疗。我们比较了参与多学科治疗模式与标准治疗模式的个体与HCV治疗的关联，并检查了与护理关联相关的因素。方法我们在魁北克省最大的省级监狱进行了一项前瞻性、准实验性的前后研究。干预组的参与者与一名护士、社会工作者和患者导航员会面，并在出院后接受预约陪同。对照组的参与者接受了出院前的预约。主要结局是与丙型肝炎治疗的联系，定义为出院后90天内与丙型肝炎治疗提供者的记录访问。使用贝叶斯逻辑回归来确定干预对连锁的影响，并分析感兴趣的协变量与连锁之间的关系。计算概率差和95%可信区间（95% CrI）。结果648名参与者接受了HCV筛查；对照组和干预组分别有19例和20例目前感染HCV。其中，2例（11%）和14例（80%）分别与释放后护理有关。干预参与者与对照组相比，与护理的联系有+ 70%（45%,88%）的差异。在干预参与者中，那些在释放后成功联系的人比那些没有联系的人更有可能与护理联系[+ 64%(14%,90%)]。结论：在未经治疗的出狱人员中，多学科治疗模式增加了与HCV治疗的联系。未来的干预措施应支持类似的模式，利用社会支持网络，最大限度地提高护理的连续性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Drug Policy SUBSTANCE ABUSE-

CiteScore

7.80

自引率

11.40%

发文量

307

审稿时长

62 days

期刊介绍： The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.