[Consensus on care for the users of the Maintenance Program with Methadone at the health centers of the province of Cádiz]

[关于加的斯省卫生中心美沙酮维持治疗项目使用者护理的共识]

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Abstract

OBJECTIVES: To reach a consensus on primary care actions concerning transmissible illnesses in users of the methadone maintenance programme. To promote coordination between levels. To find the needs of primary care professionals. DESIGN: Qualitative study based on the nominal group technique. SETTING: Cádiz province, including primary care districts, NHS hospitals and county drug-dependency centres. PARTICIPANTS: 76 health professionals: two doctors and a nurse from each health centre, selected for their experience and motivation; hospital specialists in preventive medicine and internal medicine also with experience and motivation, and with knowledge of primary care; a doctor from each county drug-dependency centre, chosen by the Provincial Drug-Dependency Management. INTERVENTIONS: The study had two phases: a) nominal group technique with homogeneous groups for each professional environment; b) modified nominal group with heterogeneous groups of professionals from all environments by hospital areas. MEASUREMENTS AND MAIN RESULTS: The final result of the study was the overall consensus in the four areas. The prioritized activities focused on "recruitment and study of patients and contacts", "educational and health promotion interventions", "immunisation programme", "monitoring therapy compliance", and "unified record of actions". What was needed to put into practice the interventions was agreed by consensus. CONCLUSIONS: Consensus techniques are a useful tool for planning primary care activities. A high degree of reproducibility can be reached if the participants are properly selected. Restrictions in being able to introduce some of the agreed interventions could be avoided with user participation and involvement of the health authorities.

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