Models of Good Practice Interventions to Enhance the Infectious Disease Care Cascade Among People Who Inject Drugs: A Qualitative Study

Author: Ilonka Horváth Tanja Schwarz Otilia Mårdh

Theme: Models of Care Year: 2022

Models of good practice (MoGP) aimed at improving community-based testing and increasing
linkage to care and adherence to treatment for HBV, HCV, HIV and TB among PWID were collected in
2020 for the update of joint ECDC/EMCDDA guidance on prevention and control of infectious
diseases among people who inject drugs (PWID). This qualitative study summarises characteristics of
interventions employed within the MoGPs with a proven impact.
A MoGP was defined as (a package of) interventions with evidence of effectiveness in certain
settings and that are likely replicable in other settings or countries. Geographical coverage included
the EU/EEA, the UK, the European Neighbouring Policy area and the Western Balkans. A two-stage
selection process of models of practice submissions included a pre-assessment based on a set of
quality criteria inspired by European Commission’s Criteria to select Best Practices in Health
Promotion and Disease Prevention and an appraisal of relevance and sustainability by an expert
panel appointed by the two agencies.
Of 21 submissions, 15 were selected as MoGPs. They emerged from projects implemented in
Belarus, Norway, Portugal, Republic of Moldova, Spain and the UK and from one EU-multi-country
project. Peer involvement (12/15) and integrated services (10/15) were most frequently cited
interventions that optimised the treatment cascade. Decentralized low-threshold approaches,
mainly based on cooperation between drug and specialized healthcare services, were utilized by the
majority of MoGPs. Most MoGPs integrated a package of interventions to improve the care cascade
and targeted more than one infection.
This collection identified practice-based evidence to successfully address the care cascade of
infections among PWID in real-life settings, in particular for HCV and HIV. When replicating the
MoGPs in other settings, consideration should be given to national legal frameworks, characteristics
of healthcare and drug services and to the particular needs of PWID populations targeted.
Disclosure of Interest Statement: 
The authors have no conflicts of interest to declare.

Download abstract