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Title: Monitoring quality and coverage of harm reduction services for people who use drugs: a consensus study
Author: Wiessing, Lucas
Ferri, Marica
Belackova, Vendula
Carrieri, Patrizia
Friedman, Samuel R.
Folch, Cinta
Dolan, Kate
Galvin, Brian
Vickerman, Peter
Lazarus, Jeffrey V.
Mravcik, Viktor
Kretzschmar, Mirjam
Sypsa, Vana
Sarasa-Renedo, Ana
Uuskula, Anneli
Paraskevis, Dimitrios
Mendao, Luis
Rossi, Diana
Gelder, Nadine van
Mitcheson, Luke
Paoli, Letizia
Diaz Gomez, Cristina
Milhet, Maitena
Dascalu, Nicoleta
Knight, Jonathan
Hay, Gordon
Kalamara, Eleni
Simon, Roland
Comiskey, Catherine
Rossi, Carla
Griffiths, Paul
Keywords: Drogoaddicció
Drug addiction
Drug addicts
Issue Date: 22-Apr-2017
Publisher: Biomed Central
Abstract: BACKGROUND AND AIMS: Despite advances in our knowledge of effective services for people who use drugs over the last decades globally, coverage remains poor in most countries, while quality is often unknown. This paper aims to discuss the historical development of successful epidemiological indicators and to present a framework for extending them with additional indicators of coverage and quality of harm reduction services, for monitoring and evaluation at international, national or subnational levels. The ultimate aim is to improve these services in order to reduce health and social problems among people who use drugs, such as human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection, crime and legal problems, overdose (death) and other morbidity and mortality. METHODS AND RESULTS: The framework was developed collaboratively using consensus methods involving nominal group meetings, review of existing quality standards, repeated email commenting rounds and qualitative analysis of opinions/experiences from a broad range of professionals/experts, including members of civil society and organisations representing people who use drugs. Twelve priority candidate indicators are proposed for opioid agonist therapy (OAT), needle and syringe programmes (NSP) and generic cross-cutting aspects of harm reduction (and potentially other drug) services. Under the specific OAT indicators, priority indicators included 'coverage', 'waiting list time', 'dosage' and 'availability in prisons'. For the specific NSP indicators, the priority indicators included 'coverage', 'number of needles/syringes distributed/collected', 'provision of other drug use paraphernalia' and 'availability in prisons'. Among the generic or cross-cutting indicators the priority indicators were 'infectious diseases counselling and care', 'take away naloxone', 'information on safe use/sex' and 'condoms'. We discuss conditions for the successful development of the suggested indicators and constraints (e.g. funding, ideology). We propose conducting a pilot study to test the feasibility and applicability of the proposed indicators before their scaling up and routine implementation, to evaluate their effectiveness in comparing service coverage and quality across countries. CONCLUSIONS: The establishment of an improved set of validated and internationally agreed upon best practice indicators for monitoring harm reduction service will provide a structural basis for public health and epidemiological studies and support evidence and human rights-based health policies, services and interventions.
Note: Reproducció del document publicat a:
It is part of: Harm Reduction Journal, 2017, vol. 14, num. 1, p. 19
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ISSN: 1477-7517
Appears in Collections:Articles publicats en revistes (ISGlobal)

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