| ObjectivesUnderstand the knowledge and medical status of hepatitis C,analyze the treatment willingness and influencing factors of HCV antibody positive patients with methadone maintenance therapy on DAAs and provide reference for the formulation of hepatitis C control measures and medical insurance policies.MethodsThis study was a cross-sectional study with the Guangdong province methadone maintenance treatment clinic as the study site by quantitative study.Using the national drug maintenance treatment information system,obtain methadone maintenance treatment patients HCV antibody test results,according to the distribution of HCV antibody positive patients,Guangzhou、Dongguan、Jiangmen、Shanwei、Yangjiang as a research site,recruit methadone maintenance treatment HCV antibody positive patients 458 people,after informed consent for one-to-one,face-to-face questionnaire survey.The contents of the survey include:Demographic characteristics of HCV antibody-positive patients,cognition of HCV antibody-positive patients on hepatitis C,treatment of HCV antibody-positive patients,family and social supportand willingness of HCV antibody-positive patients to treat DAAs.Sampling questionnaire star software was used for input and SPSS22.0 software for data analysis.Differences in group rate or composition ratio were compared by chi-square test and fisher’s exact probability test.For variables meaningful in univariate analysis,binary logistic regression analysis was used to explore the factors of HCV antibody positive patients with methadone maintenance therapy on willingness to treat DAAs.Results1.General demographic characteristics:460 people were investigated in this study.Excluding 2 unqualified questionnaires.A final total of 458 people were included.Age of 41-50 years:45.0%(206/458).Age of 51-60 years:41.5%(190/458).Male sex:87.1%(399/458).Permanent residence in cities accounted for 76.4%(350/458).Middle sc hool education or below accounted for 80.7%(370/458).Unemployed/unemployed:54.2%(248/458).Monthly discretionary of more than 1000 yuan accounted for 49.2%(230/458).The main source of living expenses is social welfare,such as the state subsist ence allowance subsidy(28.6%,131/458).The main type of medical insurance is the basic medical insurance for urban residents(65.3%,299/458).no insurance coverage w as included(14.8%,68/458).2.Knowledge and cognition of hepatitis C:Whether the correct rate of hepatitis C can cure is 51%,whether the common syringe may infect hepatitis C is 66%,whether there is a vaccine that can prevent hepatitis C is 20%,and whether chronic hepatitis C will develop cirrhosis or liver cancer is 60%.3.Previous diagnosis and treatment of hepatitis C:Still do not know their own hepatitis C antibody positive accounted for 22.7%(104/458).The first test of positive for hepatitis C antibody was found by methadone maintenance therapy clinic in 68.1%(241/354).Represents that no clinical symptoms of hepatitis C were 61.3%(217/354).no previous hepatitis C treatment accounted for 68.9%(244/354).It indicates that the individual and family economic pressure accounted for 40.0%(44/110).Having participated in DAAs treatment was42.7%(47/110).4.Social support:Before this survey,66.4%(304/458)of methadone maintenance treatment clinics had provided hepatitis C prevention and treatment knowledge publicity.58.1%(266/458)of methadone maintenance treatment clinics did not provide referral services for hepatitis C treatment.Family supported treatment accounted for 72.5%(332/458).The hope was to understand DAAs through the outpatient promotion of methadone maintenance therapy(28.9%,298/458).5.Treatment attitude of DAAs:Before this survey,84.7%(388/458)had not heard of DAAs.85.6%(392/458)wanted to obtain DAAs related information 45.8%(210/458)thought DAAs price affordability difference.22.5%(103/458)thought the availability of DAAs drugs was good.51.7%(237/458)thought DAAs prices were unreasonable.40.6%(186/458)thought the proportion of DAAs reimbursement was unreasonable.67.5%(309/458)think DAAs is convenient for medical insurance reimbursement.66.8%(306/458)said they would recommend DAAs to patients.63.3%(290/458)said they would attend DAAs treatment in the future.Most of the reasons for not participating in DAAs treatment were that HCV was not a disease and did not need treatment(14.0%,36/168).HCV had little impact on their body and life and did not need antiviral treatment(23.7%,61/168)and they had no medical insurance or low reimbursement rate and could not afford it for personal economic reasons(40.5%,104/168).6.Univariate analysis results:DAAs treatment intention and methadone maintenance treatment clinic of hepatitis C antibody positive patients,hepatitis C treatment institutions provide hepatitis C prevention knowledge propaganda,family know infection,hepatitis C in family infection,family support treatment,whether have drug friends recommended DAAs treatment,DAAs price affordability,DAAs drug purchase,DAAs price is reasonable,DAAs medical insurance reimbursement ratio,DAAs medical insurance whether the reimbursement method is convenient,cure hepatitis C this matter important degree is different.7.Multivariate analysis results:Multivariate analysis found that compared with the family supported treatment group,the family unsupported treatment group was more likely to refuse/hesitate to participate in DAAs(OR=2.408,95%CI=1.485-3.903).Compared with the group that thought DAAs reimbursement convenient,the group that thought DAAs reimbursement inconvenient was more likely to refuse/hesitate to participate in DAAs treatment(OR=2.793,95%CI=1.546-5.048).Conclusions1.Guangdong province methadone maintenance treatment of HCV antibody positive patients half of the patients do not know hepatitis C can cure,previous hepatitis c disease treatment rate is low,low awareness of DAAs,most said later will participate in DAAs treatment,family support and DAAs treatment reimbursement is convenient is the influence of DAAs treatment willingness.2.The following measures are recommended to promote patients to participate in DAAs treatment:Increase the publicity of DAAs treatment,develop "Internet+" medical service,call on HCV antibody positive patients in methadone maintenance treatment clinic to participate in community family doctor contract service,reduce hepatitis C treatment costs for special groups,establish perfect referral management system of methadone maintenance treatment clinic-hepatitis C designated medical institutions. |
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