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  1. Artikel ; Online: Expanding access to healthcare for people who use drugs and sex workers: hepatitis C elimination implications from a qualitative study of healthcare experiences in British Columbia, Canada.

    Cunningham, Nance E / Lamb, Jessica / Staller, Amanda / Krajden, Mel / Hogg, Robert S / Towle, Angela / Lima, Viviane Dias / Salters, Kate

    Harm reduction journal

    2024  Band 21, Heft 1, Seite(n) 75

    Abstract: Background: Hepatitis C virus (HCV) is a major health threat in Canada. In British Columbia (BC) province, 1.6% of the population had been exposed to HCV by 2012. Prevalence and incidence of HCV are very high in populations of people who use drugs (PWUD) ...

    Abstract Background: Hepatitis C virus (HCV) is a major health threat in Canada. In British Columbia (BC) province, 1.6% of the population had been exposed to HCV by 2012. Prevalence and incidence of HCV are very high in populations of people who use drugs (PWUD) and sex workers (SW), who may experience unique barriers to healthcare. Consequently, they are less likely to be treated for HCV. Overcoming these barriers is critical for HCV elimination. This research sought to explore the healthcare experiences of PWUD and SW and how these experiences impact their willingness to engage in healthcare in the future, including HCV care.
    Methods: Interpretive Description guided this qualitative study of healthcare experiences in BC, underpinned by the Health Stigma and Discrimination framework. The study team included people with living/lived experience of drug use, sex work, and HCV. Twenty-five participants completed in-depth semi-structured interviews on their previous healthcare and HCV-related experiences. Thematic analysis was used to identify common themes.
    Results: Three major themes were identified in our analysis. First, participants reported common experiences of delay and refusal of care by healthcare providers, with many negative healthcare encounters perceived as rooted in institutional culture reflecting societal stigma. Second, participants discussed their choice to engage in or avoid healthcare. Many avoided all but emergency care following negative experiences in any kind of healthcare. Third, participants described the roles of respect, stigma, dignity, fear, and trust in communication in healthcare relationships.
    Conclusions: Healthcare experiences shared by participants pointed to ways that better understanding and communication by healthcare providers could support positive change in healthcare encounters of PWUD and SW, who are at high risk of HCV infection. More positive healthcare encounters could lead to increased healthcare engagement which is essential for HCV elimination.
    Mesh-Begriff(e) Humans ; Hepacivirus ; British Columbia/epidemiology ; Sex Workers ; Hepatitis C/therapy ; Delivery of Health Care
    Sprache Englisch
    Erscheinungsdatum 2024-04-04
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 2146691-9
    ISSN 1477-7517 ; 1477-7517
    ISSN (online) 1477-7517
    ISSN 1477-7517
    DOI 10.1186/s12954-024-00991-2
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel: Taking care of grieving through poetry: memories of palliative care's presence or absence.

    Cunningham, Nance

    Families, systems & health : the journal of collaborative family healthcare

    2009  Band 27, Heft 1, Seite(n) 98–104

    Abstract: Families navigate loss of loved ones in a number of ways, including the creation of narratives of family experiences during the patient's illness and death. Robinson (2004) suggests that grieving family members create poetry together. Using a version of ... ...

    Abstract Families navigate loss of loved ones in a number of ways, including the creation of narratives of family experiences during the patient's illness and death. Robinson (2004) suggests that grieving family members create poetry together. Using a version of this method, the author processes losses by responding to the poems her husband wrote about the illnesses and deaths of a friend and several family members. Each poem is followed by a letter in which the author addresses the main character of the poem in order to provide new perspectives on her identity and her memories.
    Mesh-Begriff(e) Attitude to Death ; Grief ; Humans ; Palliative Care ; Poetry as Topic
    Sprache Englisch
    Erscheinungsdatum 2009-03
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 1326859-4
    ISSN 1939-0602 ; 1091-7527 ; 0736-1718
    ISSN (online) 1939-0602
    ISSN 1091-7527 ; 0736-1718
    DOI 10.1037/a0014911
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel ; Online: Public reimbursement policies in Canada for direct-acting antiviral treatment of hepatitis C virus infection: A descriptive study.

    Snell, Gaelen / Marshall, Alison D / van Gennip, Jennifer / Bonn, Matthew / Butler-McPhee, Janet / Cooper, Curtis L / Kronfli, Nadine / Williams, Sarah / Bruneau, Julie / Feld, Jordan J / Janjua, Naveed Z / Klein, Marina / Cunningham, Nance / Grebely, Jason / Bartlett, Sofia R

    Canadian liver journal

    2023  Band 6, Heft 2, Seite(n) 190–200

    Abstract: Background: Direct-acting antiviral (DAA) therapies have simplified HCV treatment, and publicly funded Canadian drug plans have eliminated disease-stage restrictions for reimbursement of DAA therapies. However other policies which complicate, delay, or ... ...

    Abstract Background: Direct-acting antiviral (DAA) therapies have simplified HCV treatment, and publicly funded Canadian drug plans have eliminated disease-stage restrictions for reimbursement of DAA therapies. However other policies which complicate, delay, or prevent treatment initiation still persist. We aim to describe these plans' existing reimbursement criteria and appraise whether they hinder treatment access.
    Methods: We reviewed DAA reimbursement policies of 16 publicly funded drug plans published online and provided by contacts with in-depth knowledge of prescribing criteria. Data were collected from May to July 2022. Primary outcomes were: (1) if plans have arranged to accept point-of-care HCV RNA testing for diagnosis; testing requirements for (2) HCV genotype, (3) fibrosis stage, and (4) chronic infection; (5) time taken and method used to approve reimbursement requests; (6) providers eligible to prescribe DAAs; and (7) restrictions on re-treatment.
    Results: Fifteen (94%) plans have at least one policy in place which limits simplified HCV treatment. Many plans continue to require results of genotype or fibrosis staging, limit eligible prescribers, and take longer than 1 day to approve coverage requests. One plan discourages treatment for re-infection.
    Conclusion: Reimbursement criteria set by publicly funded Canadian drug plans continue to limit timely, equitable access to HCV treatment. Eliminating clinically irrelevant pre-authorization testing, expanding eligible prescribers, expediting claims processing, and broadening coverage of treatment for reinfection will improve access to DAAs. The federal government could further enhance efforts by introducing a federal HCV elimination strategy or federal high-cost drug PharmaCare program.
    Sprache Englisch
    Erscheinungsdatum 2023-07-26
    Erscheinungsland Canada
    Dokumenttyp Journal Article
    ISSN 2561-4444
    ISSN (online) 2561-4444
    DOI 10.3138/canlivj-2022-0040
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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