On the path towards universal coverage of hepatitis C treatment among people receiving opioid agonist therapy (OAT) in Norway: a prospective cohort study from 2013 to 2017

Frode, Christer; Vold, Jørn Henrik; Odsbu, Ingvild; Chalabianloo, Fatemeh; Økland, Jan Magnus; Leiva, Rafael Alexander Modahl; Vickerman, Peter; Johansson, Kjell Arne

doi:10.1136/bmjopen-2019-036355

Cited by 5 publications

(5 citation statements)

References 42 publications

(49 reference statements)

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“…A newly published report from the Norwegian Institute of Public Health indicated that Norway has come a long way in eradicating hepatitis C in the general population, and that the prevalence among people who inject drugs (PWID) decreased substantially since 2016 [ 42 ]. More patients currently receive hepatitis C treatment than in previous years [ 24 , 43 , 44 ]. Based on the latest Norwegian OMT status report, > 35% of patients in Norwegian OMT have completed treatment for hepatitis C, in addition to nearly 40% not having active disease based on antigen testing.…”

Section: Discussionmentioning

confidence: 99%

Change in self-reported somatic symptoms among patients in opioid maintenance treatment from baseline to 1-year follow-up

Bjørnestad,

Vederhus,

Clausen

2024

BMC Psychiatry

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Background High somatic comorbidity is common among patients in treatment for opioid use disorder (OUD). The present study aims to investigate changes in self-reported somatic health conditions and somatic symptoms among patients entering opioid maintenance treatment (OMT) programs. Methods We used data from the Norwegian Cohort of Patients in OMT and Other Drug Treatment (NorComt) study. Of 283 patients who entered OMT, 176 were included for analysis at a 1-year follow-up. Participants provided self-reported data during structured interviews on somatic conditions, somatic symptoms, substance use severity measures, and mental distress. A multivariable linear regression analysis identified factors associated with changes in the burden of somatic symptoms. Results Patients entering OMT reported a high prevalence of somatic conditions at the beginning of treatment, with 3 of 5 patients reporting at least one. The most prevalent condition was hepatitis C, followed by asthma and high blood pressure. Patients reported experiencing a high number of somatic symptoms. The intensity of these symptoms varied across a wide spectrum, with oral health complaints and reduced memory perceived as the most problematic. Overall, for the entire sample, there was no significant change in somatic symptoms from baseline to 1 year. Further analysis indicated that those who reported a higher burden of somatic symptoms at baseline had the greatest improvement at the 1-year follow-up. A higher number of somatic conditions and higher mental distress at baseline was associated with improvements in somatic symptoms burden at follow-up. Conclusions Patients in OMT report a range of somatic conditions and somatic symptoms. Given the wide range of symptoms reported by patients in OMT, including some at high intensity levels, healthcare providers should take into consideration the somatic healthcare needs of individuals in OMT populations. Clinical trial registration Clinicaltrials.gov no. NCT05182918. Registered 10/01/2022 (the study was retrospectively registered).

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Section: Discussionmentioning

confidence: 99%

Change in self-reported somatic symptoms among patients in opioid maintenance treatment from baseline to 1-year follow-up

Bjørnestad,

Vederhus,

Clausen

2024

BMC Psychiatry

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“…Despite safe and effective hepatitis C virus treatments in Norway [33], barriers often prevent those most in need from accessing them [3], necessitating further efforts. To improve outcomes when cancer has developed, health services should focus upon improving access to cancer treatment for people with opioid use-related disorders and address potential barriers to care [34].…”

Section: Discussionmentioning

confidence: 99%

“…An important approach to reducing cancer‐related mortality is to provide preventive measures as early in life as possible, such as smoking cessation, reduced injecting drug behaviour and alcohol intake, healthy diet and sufficient physical activity [32]. Despite safe and effective hepatitis C virus treatments in Norway [33], barriers often prevent those most in need from accessing them [3], necessitating further efforts. To improve outcomes when cancer has developed, health services should focus upon improving access to cancer treatment for people with opioid use‐related disorders and address potential barriers to care [34].…”

Section: Discussionmentioning

confidence: 99%

Increased cancer incidence and mortality among people with opioid use‐related disorders: A nation‐wide cohort study

Kostovski,

Hamina,

Hjellvik

et al. 2024

Addiction

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Background and aimsStudies on cancer incidence and mortality among people with opioid use‐related disorders are lacking. We aimed to measure cancer‐specific incidence, mortality and survival among people diagnosed with opioid use‐related disorders in Norway during 2010–18.Design and settingThis was a cohort study conducted in Norway during 2010–18.ParticipantsIndividuals (n = 20 710) diagnosed with opioid use‐related disorders.MeasurementsWe conducted a cohort study utilizing a data‐linkage of national health and population registers. Information on opioid use‐related disorders was extracted from specialized healthcare, malignancies from the Cancer Registry of Norway and deaths from Cause of Death Registry. Cancer incidence and mortality were compared with the general population by calculating sex‐specific age‐standardized incidence (SIR) and mortality (SMR) ratios. One‐year survival rates were computed.FindingsCompared with the general population, people with opioid use‐related disorders were at an increased risk of developing cancer overall [SIR = 1.2, 95% confidence interval (CI) = 1.1–1.3] with a higher than twofold cancer mortality rate (SMR = 2.3, 95% CI = 2.0–2.7). Excess risk was observed for liver (12.6, 95% CI = 9.1–17.0), larynx (4.7, 95% CI = 1.7–10.2), lung (3.5, 95% CI = 2.8–4.3) and pancreas cancer (2.6, 95% CI = 1.6–4.0), whereas reduced risk was found for melanoma (0.5, 95% CI = 0.3–0.9), breast (0.6, 95% CI = 0.4–0.9) and prostate cancers (0.3, 95% CI = 0.1–0.4). Site‐specific SMRs were significantly elevated for liver (12.3, 95% CI = 8.5–17.2), lung (3.9, 95% CI = 3.0–5.0), pancreas (3.0, 95% CI = 1.7–4.8) and colon cancers (1.9, 95% CI = 1.1–3.1). The average 1‐year survival rate after a cancer diagnosis was low in liver, pancreas and colon cancer, ranging from 10 to 15% less than that of the general population.ConclusionsIn Norway, cancer incidence and cancer‐related mortality appear to be elevated among individuals with opioid use‐related disorders.

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“…Transmission of HCV is high among people who inject drugs (PWID), people with a history of injection drug use or a history of recent substance use receiving opioid maintenance treatment (OMT) [6,7]. Among patients receiving OMT in Norway, about half had chronic HCV infection [8]. Liver disease and substance-related overdose are equally signifcant causes of death among people with opioid dependence under the age of 50 [9,10].…”

Section: Introductionmentioning

confidence: 99%

Perceived Change in Quality of Life Related to Treatment of Hepatitis C Infection among People with Substance Use Disorder: A Qualitative Study

Carlsen,

Fadnes,

Napsholm

et al. 2023

Health & Social Care in the Community

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Background. The hepatitis C virus (HCV) is often associated with people who inject drugs, and with a reduction in quality of life. While earlier forms of HCV treatment had low treatment uptake, newer HCV treatment integrated with opioid maintenance treatment appears to increase treatment uptake among those who inject drugs. The aim was to explore how people who inject drugs perceive changes in quality of life after treatment of HCV infection. Methods. Four focus group discussions, and 19 individual interviews were conducted with people who inject drugs or who had previously injected drugs and received opioid agonist therapy. All participants were successfully treated for and “cured” for HCV. Data were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis. Results. The HCV treatment helped participants to let go of negative thoughts and break destructive patterns of interaction. This facilitated the restoration of social relationships with family and others. Furthermore, some participants reported a general improvement in their health. Feeling healthy meant fewer worries such as infecting others. Also, interactions with health professionals were experienced as less stigmatizing. These physical, social, and psychological improvements led to a form of “awakening” and being treated for HCV gave participants hope for the future. Conclusion. HCV treatment improves the mental and physical health in addition to play an important social function. Successful HCV treatment was associated with a greater sense of hope for the future, reconnection with significant others, and reduced feeling of stigma. Overall, improved health and social relationships contributed to improved quality of life.

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On the path towards universal coverage of hepatitis C treatment among people receiving opioid agonist therapy (OAT) in Norway: a prospective cohort study from 2013 to 2017

Cited by 5 publications

References 42 publications

Change in self-reported somatic symptoms among patients in opioid maintenance treatment from baseline to 1-year follow-up

Change in self-reported somatic symptoms among patients in opioid maintenance treatment from baseline to 1-year follow-up

Increased cancer incidence and mortality among people with opioid use‐related disorders: A nation‐wide cohort study

Perceived Change in Quality of Life Related to Treatment of Hepatitis C Infection among People with Substance Use Disorder: A Qualitative Study

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