A multidimensional education program at substance dependence treatment centers improves patient knowledge and hepatitis C care

BMC Infectious Diseases

Research Article

Rui Tato Marinho¹  Mariana Soares²  Joaquim Borges³  Teodomiro Pires⁴  Carlos Vasconcelos⁵  Cristina Polónia⁶  Helena Raposo⁷  Ana Maria Nogueira⁸  Graça Vilar⁹  António Costa^1,10 

[1] Department of Gastroenterology and Hepatology, Faculty of Medicine, University of Lisbon, Hospital Santa Maria - Centro Hospitalar Lisboa Norte, Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal;ETET Eixo Oeiras Cascais, Rua Professor Orlando Ribeiro, n.°3A, B, n.° 5A, B e n.° 7, 2740-222, Porto Salvo, Portugal;ETET da Figueira da Foz, Rua Doutor Calado 2, Figueira da Foz, 3080-153, Figueira da Foz, Portugal;ETET de Almada, Rua das Terras dos Cortes Reais n°1, 2805-025, Almada, Portugal;ETET de Gondomar, Rua Caminho de Pevidal, R/C – S/N, 4420-264, Gondomar, Portugal;ETET de Setúbal, Praça da República, 2900-587, Setúbal, Portugal;ETET do Barreiro, Rua Almirante Reis n°50, 2830-326, Barreiro, Portugal;MSD Portugal, a subsidiary of Merck & Co., Inc., Quinta da Fonte, Edifício Vasco da Gama, 19, 2770-192, Paço de Arcos, Portugal;SICAD- General-Directorate for Intervention on Addictive Behaviours and Dependencies, Avenida da República, n° 61, 3° piso, 1050-189, Lisbon, Portugal;UD Centro das Taipas, Parque de Saúde de Lisboa – Av. Brasil n.° 53, Pavilhão 2, 1° andar, 1749-002, Lisbon, Portugal;

关键词: Hepatitis C;    Health education program;    Treatment access;    Substance abuse;    People who inject drugs;    Chronic hepatitis C treatment;   

DOI  :  10.1186/s12879-016-1883-6

 received in 2016-02-03, accepted in 2016-10-01,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundHCV treatment among people who inject drugs (PWID) is low. Education programs may be suitable strategies to improve patients’ knowledge about their condition and to overcome barriers to access treatment.MethodsThe Health Educational Program (HEP) consisted of patient workshops and educational videos and leaflets, and healthcare professionals’ workshops. HEP was implemented at seven substance dependence treatment centers (STDC) in Portugal. The study comprised two cross-sectional evaluations conducted before and after HEP. At both evaluations, adult patients with confirmed HCV diagnosis and registered in the STDC were consecutively included. For patients that completed both evaluations, the overall knowledge score were calculated and compared with McNemar test. Linear regression modelling was used to evaluate factors associated with baseline knowledge. Rates of referral and attendance to referral specialist, treatment proposal, initiation and retention at both evaluations were also compared with McNemar test.ResultsOverall, 504 patients with chronic hepatitis C were included: 78 % male, mean age 42.3 ± 6.6 years, 14 % school education ≤ 4 years, disease duration 11.0 ± 6.0 years and 26 % HIV co-infected. A higher baseline knowledge was independently associated with educational level ≥ 10 years (regression coefficient [B] =15.13, p < 0.001), current use of intravenous drugs (B = 7.99, p = 0.038), previous referral for treatment (B = 4.26, p = 0.008) and previous HCV treatment (B = 5.40, p = 0.003). Following HEP, mean knowledge score increased from 69 % to 79 % (p < 0.001). The rate of patient referral to a liver specialist increased from 56.2 % to 67.5 % (p < 0.001).ConclusionsAn HEP conducted at STDCs improved significantly patient knowledge about hepatitis C, even among patients with a high baseline knowledge. The HEP has also increased the rate of referral to the liver specialist and showed a great potential to support healthcare professionals in managing HCV. Education programs may promote treatment access among PWID, a population that represents the majority of HCV infected patients.

【 授权许可】

CC BY   
© The Author(s). 2016