Relationship between patient activation and utilisation of health care and harm reduction services among people who inject drugs in Baltimore, Maryland.

Autor: Baker P; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA.; Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, USA., Genberg BL; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA., Astemborski J; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA., Mehta SH; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA., Kirk GD; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA.; School of Medicine, Johns Hopkins University, Baltimore, USA., Cepeda J; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA.
Jazyk: angličtina
Zdroj: Drug and alcohol review [Drug Alcohol Rev] 2024 Nov; Vol. 43 (7), pp. 1859-1864. Date of Electronic Publication: 2024 Jul 01.
DOI: 10.1111/dar.13893
Abstrakt: Introduction: Given structural barriers, access to services is key for preventing drug-related harms and managing chronic disease among people who inject drugs (PWID). The Patient Activation Measure (PAM), a validated scale to assess self-efficacy in navigating one's own health care, was operationalised to improve service utilisation and outcomes but has not been assessed among PWID. We characterised PAM and its association with healthcare and harm reduction utilisation among PWID in the AIDS Linked to IntraVenous Experience cohort in Baltimore.
Methods: From 2019 to 2020, participants completed surveys on PAM, service utilisation and drug use. We used log-binomial regression to identify correlates of "Lower" PAM and modelled the association between lower PAM and service utilisation, stratified by recent IDU.
Results: Participants (n = 351) were primarily male (67%), Black (85%) and 24% reported recent IDU. Lower PAM was significantly more common in those reporting IDU (aPR 1.45; 95% CI 1.03, 2.04), heavy alcohol (aPR 1.77; 95% CI 1.24, 2.51) and marijuana (aPR: 1.70; 95% CI 1.23, 2.36) but less common among women (aPR 0.57; 95% CI 0.38, 0.84) and those living with HIV (APR 0.52; 95% CI 0.35, 0.78). In modelling service utilisation, lower PAM was associated with a lower prevalence of methadone utilisation (aPR 0.27; 95% CI 0.09, 0.84) among those reporting IDU, but a higher prevalence of methadone utilisation (aPR 2.72; 95% CI 1.46, 5.08) among those not reporting IDU, after controlling for correlates of PAM.
Discussion and Conclusion: PAM-tailored interventions targeting methadone utilisation warrant consideration but should account for socio-structural barriers to utilisation and correlates of PAM among PWID.
(© 2024 Australasian Professional Society on Alcohol and other Drugs.)
Databáze: MEDLINE
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