scholarly journals Waiting room ambience and provision of opioid substitution therapy in general practice

2012 ◽  
Vol 196 (6) ◽  
pp. 391-394 ◽  
Author(s):  
Simon M Holliday ◽  
Parker J Magin ◽  
Janet S Dunbabin ◽  
Ben D Ewald ◽  
Julie‐Marie Henry ◽  
...  
Keyword(s):  
General Practice ◽  
Substitution Therapy ◽  
Opioid Substitution Therapy ◽  
Waiting Room ◽  
Opioid Substitution

scholarly journals Hepatitis C Prevalence and Management Among Patients Receiving Opioid Substitution Treatment in General Practice in Ireland: Baseline Data from a Feasibility Study (Preprint)

2018 ◽  
Author(s):  
Ross Murtagh ◽  
Davina Swan ◽  
Eileen O'Connor ◽  
Geoff McCombe ◽  
John S. Lambert ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Baseline Data ◽  
Substitution Treatment ◽  
Substitution Therapy ◽  
Opioid Substitution Therapy ◽  
Opioid Substitution Treatment ◽  
Hcv Screening ◽  
Clinical Records ◽  
Opioid Substitution

BACKGROUND Hepatitis C virus (HCV) infection is a major cause of chronic liver disease and death. Injection drug use is now one of the main routes of transmission of HCV in Ireland and globally with an estimated 80% new infections occurring among people who inject drugs (PWID). OBJECTIVE We aimed to examine whether patients receiving opioid substitution therapy in primary care practices in Ireland were receiving guideline-adherent care regarding HCV screening. Ireland has developed a model of care for delivering opioid substitution treatment in the primary care setting. We conducted this study given the shift of providing care for PWID from secondary to primary care settings, in light of current guidelines aimed at scaling up interventions to reduce chronic HCV infection and associated mortality. METHODS We included baseline data from the Dublin site of the Heplink study, a feasibility study focusing on developing complex interventions to enhance community-based HCV treatment and improve the HCV care pathway between primary and secondary care. We recruited 14 opioid substitution treatment-prescribing general practices that employed the administration of opioid substitution therapy from the professional networks and databases of members of the research consortium. A standardized nonprobability sampling framework was used to identify 10 patients from each practice to participate in the study. Patients were eligible if aged ≥18 years, on opioid substitution treatment, and attending the practice for any reason during the recruitment period. The baseline data were collected from the clinical records of participating patients. We collected and analyzed data on demographic characteristics, care processes and outcomes regarding HCV and other blood-borne viruses, urinalysis test results, alcohol use disorders, chronic illness, and health service utilization. We examined whether patients received care concordant with guidelines related to HCV screening and care. RESULTS The baseline data were collected from clinical records of 134 patients; 72.2% (96/134) were males; (mean age 43, SD 7.6; range 27-71 years); 94.8% (127/134) of patients had been tested for anti-HCV antibody in their lifetime; of those, 77.9% (99/127) tested positive. Then, 83.6% (112/134) of patients had received an HIV antibody test in their lifetime; of those, 6.3% (7/112) tested HIV positive. Moreover, 66.4% (89/134) of patients had been tested for hepatitis B virus in their lifetime and 8% (7/89) of those were positive. In the 12 months before the study, 30.6% (41/134) of patients were asked about their alcohol use by their general practitioner, 6.0% (8/134) received a brief intervention, and 2.2% (3/134) were referred to a specialist addiction or alcohol treatment service. CONCLUSIONS With general practice and primary care playing an increased role in HCV care, this study highlights the importance of prioritizing the development and evaluation of real-world clinical solutions that support patients from diagnosis to treatment completion.

scholarly journals Efficacy and Safety of Ombitasvir/Paritaprevir/Ritonavir and Dasabuvir With or Without Ribavirin in Patients With Chronic Hepatitis C Virus Genotype 1 Infection Receiving Opioid Substitution Therapy: A Post Hoc Analysis of 12 Clinical Trials

2018 ◽  
Vol 5 (11) ◽  
Author(s):  
Jason Grebely ◽  
Massimo Puoti ◽  
Heiner Wedemeyer ◽  
Curtis Cooper ◽  
Mark S Sulkowski ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Hepatitis C ◽  
Treatment Adherence ◽  
Efficacy And Safety ◽  
Substitution Therapy ◽  
Hcv Treatment ◽  
Opioid Substitution Therapy ◽  
Direct Acting Antiviral ◽  
Direct Acting ◽  
Opioid Substitution

Abstract Background We evaluated the impact of opioid substitution therapy (OST) on the completion, adherence, efficacy, and safety of the 3-direct-acting antiviral regimen of ombitasvir, paritaprevir (identified by AbbVie and Enanta) co-dosed with ritonavir, and dasabuvir ± ribavirin among patients infected with hepatitis C virus (HCV) genotype (GT) 1, with or without compensated cirrhosis. Methods Data were pooled from GT1-infected patients enrolled in 12 phase II/III/IIIb clinical trials and categorized by use of OST. Patients with ongoing drug use were excluded. HCV treatment completion, treatment adherence (≥90%), sustained virologic response at post-treatment week 12 (SVR12), and adverse events were assessed. Results Of 4747 patients, 3% (n = 149) received OST. Among patients receiving OST vs those not receiving OST, 82% (n = 122) vs 52% (n = 2409) had GT1a infection; 76% (n = 113) vs 61% (n = 2792) were treatment naïve; and 17% (n = 25) vs 18% (n = 830) had cirrhosis, respectively. The proportion of patients completing HCV treatment did not differ between those receiving and not receiving OST (97% [n = 144] vs 98% [n = 4510], respectively), whereas adherence to treatment was reduced in patients receiving vs those not receiving OST (88% [n = 105] vs 97% [n = 4057], respectively). SVR12 was similar between patients receiving and not receiving OST (94% [n = 140] vs 96% [n = 4405], respectively; P = .273). Treatment was well tolerated. Conclusions Although treatment adherence was lower in patients receiving OST vs those not receiving OST, treatment completion and SVR12 were similar between groups. These data support the use of direct-acting antiviral therapies in patients receiving OST.

Opioid substitution therapy or hidden opioids are a minefield for nalmefene: an atypical case series of 11 patients in Lorraine

2017 ◽  
Vol 31 (5) ◽  
pp. 574-579 ◽  
Author(s):  
Melissa Yéléhé-Okouma ◽  
Hervé Martini ◽  
Jérémie Lemarié ◽  
Pierre Labroca ◽  
Nadine Petitpain ◽  
...  
Keyword(s):  
Case Series ◽  
Substitution Therapy ◽  
Opioid Substitution Therapy ◽  
Atypical Case ◽  
Opioid Substitution

scholarly journals Opioid substitution therapy as a strategy to reduce deaths in prison: Retrospective cohort study

2015 ◽  
Vol 146 ◽  
pp. e168 ◽  
Author(s):  
Sarah Larney ◽  
Natasa Gisev ◽  
Michael Farrell ◽  
Timothy Dobbins ◽  
Lucy Burns ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Substitution Therapy ◽  
Opioid Substitution Therapy ◽  
Opioid Substitution

An examination of the influences on New South Wales general practitioners regarding the provision of opioid substitution therapy

2013 ◽  
pp. n/a-n/a ◽  
Author(s):  
Simon Holliday ◽  
Parker Magin ◽  
Christopher Oldmeadow ◽  
John Attia ◽  
Janet Dunbabin ◽  
...  
Keyword(s):  
General Practitioners ◽  
New South ◽  
New South Wales ◽  
Substitution Therapy ◽  
Opioid Substitution Therapy ◽  
South Wales ◽  
Opioid Substitution
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