Suchergebnisse

Background. Methamphetamine and opioid use disorders (MUD/OUD) are increasing in the US, paralleled by a surge in hepatitis C virus (HCV). HCV is curable with direct-acting antiviral medication (DAA), but people with HCV who use drugs often don't receive it. We estimated differences in DAA by substance type among people with HCV in Arkansas. Methods. We used a statewide medical claims database to identify HCV cases who also had MUD, OUD, and/or AUD (pooled 2018–2022; N = 5439). We used multiple logistic regression to model DAA receipt, adjusted for relevant covariates. Results. Only 10% of our sample received DAA. The lowest predicted probabilities of DAA receipt were among people who used methamphetamine (4.5%) and those covered by Medicaid (5.4%). Conclusion. Arkansas Medicaid has the strictest requirements for initiating DAA in the country. Public health efforts that reduce exposure to HCV among people who use drugs will reduce the HCV burden in Arkansas.

INTRODUCTION: Fatal overdoses from opioids increased four-fold from 1999 to 2009, and they are now the leading cause of death among Americans under 50. Legislation has been passed by every state to increase access to naloxone but dispensing by community pharmacies remains low. OBJECTIVES: The objective of this study was to pilot test a proactive opioid overdose counseling intervention and a passive naloxone intervention, and the implementation strategies developed to support their delivery, in rural community pharmacies on relevant implementation outcomes. METHODS: The interventions, implementation strategies, and the overall pilot study approach were developed in a collaborative partnership with a regional supermarket pharmacy chain. They selected 2 rural pharmacies to participate in the pilot study and 2 non-intervention pharmacies to serve as comparison sites. Two interventions were pilot tested in the 2 intervention pharmacies: 1)a proactive opioid overdose counseling intervention and 2) a passive naloxone intervention. An explanatory sequential mixed-methods design was utilized to evaluate adoption, feasibility, acceptability, and appropriateness outcomes after the 3-month observation period. RESULTS: Between the 2 intervention pharmacies, 130 patients received the opioid overdose counseling intervention. 44 (33.8%) were prescribed and dispensed naloxone. Zero naloxone prescriptions were written or dispensed at the comparison pharmacies. Interviews with pharmacy staff found the interventions to be feasible, acceptable, and appropriate in their settings. CONCLUSION: This small scale pilot study in partnership with a regional supermarket pharmacy chain had positive results with a third of patients who received the opioid overdose counseling intervention being dispensed naloxone. However, the majority of patients did not receive naloxone indicating additional revisions to the intervention components and/or implementation strategies are needed to improve the overall impact of the interventions.