注射吸毒者的患者导航员工作联盟和丙型肝炎治疗级联结果：HERO研究

IF 3.9 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-02-21 DOI:10.1016/j.drugalcdep.2025.112617

Snehal S. Lopes , J. Edward Dotherow , Irene Pericot-Valverde , Paula J. Lum , Lynn E. Taylor , Shruti H. Mehta , Judith I. Tsui , Judith Feinberg , Arthur Y. Kim , Brianna L. Norton , Kimberly Page , Cristina Murray-Krezan , Jessica Anderson , Alison Karasz , Julia Arnsten , Phillip Moschella , Moonseong Heo , Alain H. Litwin , the HERO study group

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引用次数: 0

摘要

将患者导航（PN）干预整合到丙型肝炎病毒（HCV）消除工作中，可以提高从筛查到治愈的HCV治疗级联结果。尽管如此，对于患者-导航员工作联盟如何影响PN干预的有效性知之甚少。这项针对丙型肝炎病毒注射吸毒者（PWID）的研究旨在评估患者-导航员工作联盟与丙型肝炎病毒治疗级联结果之间的关系。方法：本研究利用丙型肝炎真实选项（HERO）研究数据，对治疗结束时接受患者导航员工作联盟调查的PN组参与者进行调查（N = 227）。工作联盟采用16项简短联盟量表（BAI）进行测量。计算平均BAI总体和子量表（“债券”和“任务/目标”）得分。结果包括持续病毒学应答（SVR）、HCV治疗依从性、持续时间、完成情况和HCV再感染。线性和逻辑回归模型分别用于连续和二元结果。结果整体工作联盟越强，实现SVR的可能性越高[aOR (95% CI) = 6.31 (1.68, 23.77)；p = .007]。同样，“纽带”越强，SVR的可能性越高[7.65 (1.79,32.76)；p =。[00:06]和“任务/目标”[4.50 (1.35,15.02)；p =。[14]工作联盟。然而，工作联盟与其他结果无显著相关。更强的患者-导航员工作联盟与实现HCV治愈有关，但与治疗依从性或完成无关。需要更多的研究来了解增强患者-导航员工作联盟的因素，以便未来的PN干预可能进一步纳入这些特征，以改善PWID患者的HCV结局。

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Patient–navigator working alliance and hepatitis C treatment cascade outcomes among persons who inject drugs: The HERO study

Introduction

Integrating patient navigation (PN) interventions in hepatitis C virus (HCV) elimination efforts enhances HCV treatment cascade outcomes from screening to cure. Nonetheless, little is known about how the patient–navigator working alliance influences the effectiveness of PN interventions. This study among persons who inject drugs (PWID) living with HCV aimed to assess the association between patient–navigator working alliance and HCV treatment cascade outcomes.

Methods

This study utilized the Hepatitis C Real Options (HERO) study data for a subset of participants from the PN arm who responded to the patient–navigator working alliance survey at the end-of-treatment timepoint (N = 227). Working alliance was measured using the 16-item Brief Alliance Inventory (BAI). The average BAI overall and subscales (‘bonds’ and ‘tasks/goals’) scores were calculated. Outcomes included sustained virologic response (SVR), HCV treatment adherence, duration, completion and HCV reinfection. Linear and logistic regression models were used for continuous and binary outcomes, respectively.

Results

Stronger overall working alliance was associated with a higher likelihood of achieving SVR [aOR (95 % CI) = 6.31 (1.68, 23.77); p = .007]. Similarly, the likelihood of SVR was higher for stronger ‘bonds’ [7.65 (1.79, 32.76); p = .006] and 'tasks/goals’ [4.50 (1.35, 15.02); p = .014] working alliance. However, working alliance was not significantly associated with the other outcomes.

Discussion

A stronger patient–navigator working alliance is associated with achieving HCV cure but not treatment adherence or completion. More studies are needed to understand the factors that enhance patient–navigator working alliance so that future PN interventions may further incorporate those features to improve HCV outcomes among PWID.

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来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.