2026-04-18T02:00:50Zhttps://recercat.cat/oai/request

oai:recercat.cat:2445/1109352025-12-05T01:16:34Zcom_2072_1057col_2072_478917

00925njm 22002777a 4500 dc Wiessing, Lucas author Ferri, Marica author Belackova, Vendula author Carrieri, Patrizia author Friedman, Samuel R. author Folch, Cinta author Dolan, Kate author Galvin, Brian author Vickerman, Peter author Lazarus, Jeffrey V. author Mravcik, Viktor author Kretzschmar, Mirjam author Sypsa, Vana author Sarasa-Renedo, Ana author Uusküla, Anneli author Paraskevis, Dimitrios author Mendao, Luis author Rossi, Diana author Gelder, Nadine van author Mitcheson, Luke author Paoli, Letizia author Diaz Gomez, Cristina author Milhet, Maitena author Dascalu, Nicoleta author Knight, Jonathan author Hay, Gordon author Kalamara, Eleni author Simon, Roland author Comiskey, Catherine author Rossi, Carla author Griffiths, Paul author 2017-05-12T11:57:15Z 2017-05-12T11:57:15Z 2017-04-22 2017-05-03T18:01:52Z 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. Drogoaddicció Epidemiology Drogoaddictes Drug addiction Epidemiologia Drug addicts Monitoring quality and coverage of harm reduction services for people who use drugs: a consensus study