TY - JOUR
KW - Consensus
KW - Harm Reduction
KW - Humans
KW - Quality of Health Care
KW - Substance-Related Disorders/therapy
KW - Best practice
KW - Coverage
KW - Drug services
KW - Epidemiology
KW - Evidence-based
KW - HCV
KW - HIV
KW - Indicators
KW - Injecting drug users/IDU
KW - Interventions
KW - Knowledge exchange
KW - monitoring
KW - People who inject drugs/PWID
KW - People who use drugs/PWUD
KW - Substance Abuse
AU - Lucas Wiessing
AU - Marica Ferri
AU - Vendula Belackova
AU - Patrizia Carrieri
AU - Samuel R. Friedman
AU - Cinta Folch
AU - Kate Dolan
AU - Brian Galvin
AU - Peter Vickerman
AU - Jeffrey V. Lazarus
AU - Viktor Mravcik
AU - Mirjam Kretzschmar
AU - Vana Sypsa
AU - Ana Sarasa-Renedo
AU - Anneli Uuskula
AU - Dimitrios Paraskevis
AU - Luis Mendao
AU - Diana Rossi
AU - Nadine van Gelder
AU - Luke Mitcheson
AU - Letizia Paoli
AU - Cristina Diaz Gomez
AU - Maitena Milhet
AU - Nicoleta Dascalu
AU - Jonathan Knight
AU - Gordon Hay
AU - Eleni Kalamara
AU - Roland Simon
AU - EUBEST working group
AU - Catherine Comiskey
AU - Carla Rossi
AU - Paul Griffiths
A1 - 
AB - 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.
AD - European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Praca Europa 1, Cais do Sodre, 1249-289, Lisbon, Portugal. Lucas.Wiessing@emcdda.europa.eu.; European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Praca Europa 1, Cais do Sodre, 1249-289, Lisbon, Portugal.; Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.; National Institute for Mental Health, Prague, Czech Republic.; Uniting Medically Supervised Injecting Centre, Sydney, Australia.; Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France.; ORS PACA, Marseille, France.; Institute of Infectious Disease Research, National Development and Research Institutes, New York, USA.; Centre d'Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Barcelona, Spain.; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.; Program of International Research and Training, National Drug and Alcohol Research Centre, The University of New South Wales (UNSW), Sydney, Australia.; Health Research Board, Dublin, Ireland.; School of Social and Community Medicine, University of Bristol, Bristol, UK.; CHIP, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.; Barcelona Institute of Global Health (ISGlobal), Hospital Clinic, University of Barcelona, Barcelona, Spain.; Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.; National Institute for Mental Health, Prague, Czech Republic.; National Monitoring Centre for Drugs and Addiction, Prague, Czech Republic.; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.; Department of Hygie(TRUNCATED)
BT - Harm reduction journal
C5 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
CP - 1
CY - England
DO - 10.1186/s12954-017-0141-6
IS - 1
JF - Harm reduction journal
LA - eng
M1 - Journal Article
N2 - 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.
PP - England
PY - 2017
SN - 1477-7517; 1477-7517
SP - 19
T1 - Monitoring quality and coverage of harm reduction services for people who use drugs: a consensus study
T2 - Harm reduction journal
TI - Monitoring quality and coverage of harm reduction services for people who use drugs: a consensus study
U1 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
U2 - 28431584
U3 - 10.1186/s12954-017-0141-6
VL - 14
VO - 1477-7517; 1477-7517
Y1 - 2017
Y2 - Apr 22
ER -