Health programmes and services addressing the prevention and management of infectious diseases in persons who inject drugs in Canada: a systematic integrative review protocol

Álvarez, Elizabeth; Joshi, Siddharth; Lokker, Cynthia; Wang, Annie; Pavalagantharajah, Sureka; Qiu, Yun; Sidhu, Hargun; Mbuagbaw, Lawrence; Qutob, Majdi; Henedi, Alia; Levine, Mitchell; Lennox, Robin; Tarride, Jean‐Éric; Kalina, Dale

doi:10.1136/bmjopen-2019-035188

Cited by 4 publications

(6 citation statements)

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“…This research followed an integrative systematic review as outlined by Whittemore and Knafl 17 and has been previously described elsewhere. 18 An integrative systematic review may be used to gather diverse and broad evidence, allowing the inclusion of varying methodologies to understand the breadth of a health issue. 18 This manuscript follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines adapted for scoping reviews.…”

Section: Methodsmentioning

confidence: 99%

“…18 An integrative systematic review may be used to gather diverse and broad evidence, allowing the inclusion of varying methodologies to understand the breadth of a health issue. 18 This manuscript follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines adapted for scoping reviews. 19 Literature search PubMed, CINAHL and Web of Science Core Collection electronic databases were searched for empirical literature between 2008 and 6 June 2019 (one additional year from that indicated in the published protocol paper 18 to include studies from at least 10 years).…”

Section: Methodsmentioning

confidence: 99%

“…18 This manuscript follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines adapted for scoping reviews. 19 Literature search PubMed, CINAHL and Web of Science Core Collection electronic databases were searched for empirical literature between 2008 and 6 June 2019 (one additional year from that indicated in the published protocol paper 18 to include studies from at least 10 years). Additionally, PHAC, the Canadian Institute for Substance Use Research and Canadian Centre on Substance Use and Addiction websites were searched.…”

Section: Methodsmentioning

confidence: 99%

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Health programmes and services addressing the prevention and management of infectious diseases in people who inject drugs in Canada: a systematic integrative review

et al. 2021

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ObjectivesPeople who inject drugs (PWID) experience a high burden of injection drug use-related infectious disease and challenges in accessing adequate care. This study sought to identify programmes and services in Canada addressing the prevention and management of infectious disease in PWID.DesignThis study employed a systematic integrative review methodology. Electronic databases (PubMed, CINAHL and Web of Science Core Collection) and relevant websites were searched for literature published between 2008 and 2019 (last search date was 6 June 2019). Eligible articles and documents were required to address injection or intravenous drug use and health programmes or services relating to the prevention or management of infectious diseases in Canada.ResultsThis study identified 1607 unique articles and 97 were included in this study. The health programmes and services identified included testing and management of HIV and hepatitis C virus (n=27), supervised injection facilities (n=19), medication treatment for opioid use disorder (n=12), integrated infectious disease and addiction programmes (n=10), needle exchange programmes (n=9), harm reduction strategies broadly (n=6), mobile care initiatives (n=5), peer-delivered services (n=3), management of IDU-related bacterial infections (n=2) and others (n=4). Key implications for policy, practice and future research were identified based on the results of the included studies, which include addressing individual and systemic factors that impede care, furthering evaluation of programmes and the need to provide comprehensive care to PWID, involving medical care, social support and harm reduction.ConclusionsThese results demonstrate the need for expanded services across a variety of settings and populations. Our study emphasises the importance of addressing social and structural factors that impede infectious disease care for PWID. Further research is needed to improve evaluation of health programmes and services and contextual factors surrounding accessing services or returning to care.PROSPERO registration numberCRD42020142947.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Health programmes and services addressing the prevention and management of infectious diseases in people who inject drugs in Canada: a systematic integrative review

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“…Two published protocols of systematic reviews in progress focused on health services and interventions to treat or prevent viral and bacterial infections among PWID. 66 67 …”

Section: Methods and Analysismentioning

confidence: 99%

“…Inclusion criteria and definition of PWID. Implications for policy and/or practice, as reported by authors 66. ► Implications for research, as reported.…”

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confidence: 93%

Social and structural determinants of injecting-related bacterial and fungal infections among people who inject drugs: protocol for a mixed studies systematic review

Lewer

Bonn²,

Webster

et al. 2021

BMJ Open

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IntroductionInjecting-related bacterial and fungal infections are a common complication among people who inject drugs (PWID), associated with significant morbidity and mortality. Invasive infections, including infective endocarditis, appear to be increasing in incidence. To date, preventive efforts have focused on modifying individual-level risk behaviours (eg, hand-washing and skin-cleaning) without much success in reducing the population-level impact of these infections. Learning from successes in HIV prevention, there may be great value in looking beyond individual-level risk behaviours to the social determinants of health. Specifically, the risk environment conceptual framework identifies how social, physical, economic and political environmental factors facilitate and constrain individual behaviour, and therefore influence health outcomes. Understanding the social and structural determinants of injecting-related bacterial and fungal infections could help to identify new targets for prevention efforts in the face of increasing incidence of severe disease.Methods and analysisThis is a protocol for a systematic review. We will review studies of PWID and investigate associations between risk factors (both individual-level and social/structural-level) and the incidence of hospitalisation or death due to injecting-related bacterial infections (skin and soft-tissue infections, bacteraemia, infective endocarditis, osteomyelitis, septic arthritis, epidural abscess and others). We will include quantitative, qualitative and mixed methods studies. Using directed content analysis, we will code risk factors for these infection-related outcomes according to their contributions to the risk environment in type (social, physical, economic or political) and level (microenvironmental or macroenvironmental). We will also code and present risk factors at each stage in the process of drug acquisition, preparation, injection, superficial infection care, severe infection care or hospitalisation, and outcomes after infection or hospital discharge.Ethics and disseminationAs an analysis of the published literature, no ethics approval is required. The findings will inform a research agenda to develop and implement social/structural interventions aimed at reducing the burden of disease.PROSPERO registration numberCRD42021231411.

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Infectious diseases, comorbidities and outcomes in hospitalized people who inject drugs (PWID)

et al. 2022

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Injection drug use poses a public health challenge. Clinical experience indicates that people who inject drugs (PWID) are hospitalized frequently for infectious diseases, but little is known about outcomes when admitted. Charts were identified from local hospitals between 2013–2018 using consultation lists and hospital record searches. Included individuals injected drugs in the past six months and presented with infection. Charts were accessed using the hospital information system, undergoing primary and secondary reviews using Research Electronic Data Capture (REDCap). The Wilcoxon rank-sum test was used for comparisons between outcome categories. Categorical data were summarized as count and frequency, and compared using Fisher’s exact test. Of 240 individuals, 33% were admitted to the intensive care unit, 36% underwent surgery, 12% left against medical advice (AMA), and 9% died. Infectious diagnoses included bacteremia (31%), abscess (29%), endocarditis (29%), cellulitis (20%), sepsis (10%), osteomyelitis (9%), septic arthritis (8%), pneumonia (7%), discitis (2%), meningitis/encephalitis (2%), or other (7%). Sixty-six percent had stable housing and 60% had a family physician. Fifty-four percent of patient-initiated discharges were seen in the emergency department within 30 days and 29% were readmitted. PWID are at risk for infections. Understanding their healthcare trajectory is essential to improve their care.

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Health programmes and services addressing the prevention and management of infectious diseases in persons who inject drugs in Canada: a systematic integrative review protocol

Cited by 4 publications

References 122 publications

Health programmes and services addressing the prevention and management of infectious diseases in people who inject drugs in Canada: a systematic integrative review

Health programmes and services addressing the prevention and management of infectious diseases in people who inject drugs in Canada: a systematic integrative review

Social and structural determinants of injecting-related bacterial and fungal infections among people who inject drugs: protocol for a mixed studies systematic review

Infectious diseases, comorbidities and outcomes in hospitalized people who inject drugs (PWID)

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