Evaluation Of The Provision Of Single Use Citric Acid Sachets To ...
Evaluation Of The Provision Of Single Use Citric Acid Sachets To ... Evaluation Of The Provision Of Single Use Citric Acid Sachets To ...
5of this research, in December 2001 pharmacy exchanges in Greater Glasgow startedoffering 100mg single use sachets of citric acid to IDUs and, in March 2002, pharmacy andneedle ex changes in Lana rkshire follo we d suit. This pro vision was introduced with thesupport of Greater Glasgow and Lanarkshire DATs, the Home Office, Strathclyde Police,Grea te r Glasgo w P rimary Ca re Trust and the Ro ya l Pha rmaceutica l So cie ty in Sco tland.The 100mg single use citric acid sachets provided are manufactured and packed insurroundings that comply with the pharmaceutical industry standards of GoodManufacturing Practice (GMP). The sachets themselves are made from a combination ofpaper, plastic and aluminium foil, which ensures they remain airtight, water resistant andfree from contamination.As the sachets are designed for single use, they decrease the risk of contamination fromsharing between IDUs and encourage hygienic injecting techniques. In addition, it ishoped that providing citric acid sachets in this way will increase both the number of peopleattending and the number of visits to the needle exchange. Despite these clear benefits,citric acid, like a ll a cidifie rs, is not designed fo r inje cting a nd ca n lead to ve in damage . It isthe re fo re impo rtant tha t the smalle st po ssible amount is used. Tex t on the ex te rio r o f thesachets advises IDUs to use as little citric as possible and to discard whatever remains.Each sachet also carries the warning that injecting citric acid can damage veins. Thisinformation and further injecting advice is also offered to IDUs on the small flyer suppliedwith the sachets and on the box in which the sachets are sometimes supplied to users.(Furthe r info rmatio n o n the sa chets, leafle ts a nd info rmation distribute d ca n be fo und inAppendices C and D.)While the pro vision o f citric a cid sa che ts in the UK is rela tive ly ne w, a sim ila r se rvice ha sbeen available in some European countries for some time now. There it has increased theuse of needle exchange services, reduced the use of more dangerous acidifiers, beenpo pula r with IDUs and impro ved the ir re latio nship with needle ex cha nge staff (P resto n &Derricott, 2002). A small pilot study carried out by the Hungerford Mobile Exchange Teamin London has also produced positive results (Wilkinson, 2002).The Effective Interventions Unit (Scottish Executive), Greater Glasgow Primary Care NHSTrust and Lanarkshire Primary Care NHS Trust provided the funding necessary toinvestiga te if the provisio n o f citric a cid is just a s successful in Grea te r Gla sgo w andLanarkshire.
6CHAPTER 2 METHODOLOGYAims & ObjectivesThe study aimed to assess the acceptability, effectiveness and efficiency of the provisionof 100mg single use sachets of citric acid to injecting drug users. The objectives were toassess:• If the amount of citric a cid is sufficient to disso lve the amount of he ro in use d pe rinjection.• If the provision of one sachet per one needle/syringe is adequate for the needs ofinjectors.• The number of citric burns experienced using the sachets.• If the uptake of needles/syringes from exchanges has increased since theintroduction of the sachets.Project ManagementA working group comprising Avril Taylor (Chair in Public Health, University of Paisley), KayRoberts (Area Pharmacy Specialist – Drug Misuse, Greater Glasgow Primary Care NHST rus t), Da vid Rob inso n (P ro je ct Co -o rd inato r, La narksh ire Ha rm Redu ctio n Team ), BrianRae (Research Manager, Greater Glasgow Primary Care NHS Trust) and Jennifer Garden(Re sea rch Office r, Sco ttish Cen tre fo r I nfe ctio n an d En vironmen ta l Hea lth) me t re gu la rlyto ratify the proposed interview schedule and methodology.Sampling StrategyTwo pharmacy exchanges in Greater Glasgow, two pharmacy exchanges in Lanarkshireand two fixed site needle exchanges in Lanarkshire agreed to take part in the study. Theseex cha nges we re invited to pa rticipa te in the pro je ct as the y a re among the busie s t inGreater Glasgow and Lanarkshire and allowed for a large number of injecting drug usersto be approached. Three hundred and sixty injecting drug users who attended theseneedle exchanges were recruited to the study between August and November 2002. Theprovision of the single use citric acid sachets began in Greater Glasgow in December 2001and in Lanarkshire in March 2002. This meant that all the participants would have had theopportunity to use the single use citric acid sachets at the time of being interviewed. Onehundred and twenty participants were from the Lanarkshire NHS Board area and 240 werefrom the Greater Glasgow NHS Board area. This sample represents 10% of all injectorswho attended needle exchanges in Lanarkshire in August 2001 and 5% of all contacts toGlasgow pharmacies per month over the period September 2000 to March 2001 (thenumber of individuals using Glasgow pharmacies is not available).Potential participants were approached after the needle exchange staff had served them.I nte rvie ws we re ca rried o ut the re and the n in a quie t co rne r of the ex change. Ea chinte rvie w took less than ten minutes to comple te a nd wa s comple te ly a nonymous andconfidential. All participants were offered a bar of chocolate and a can of juice for takingthe time to pa rticipate in the s tudy.
- Page 1 and 2: Effective Interventions UnitEVALUAT
- Page 3 and 4: iABSTRACTThree hundred and sixty in
- Page 5 and 6: 2diagnosed cases of HIV infected in
- Page 7: 4and is so ld in poo rly so luble b
- Page 11 and 12: 8CHAPTER 3 RESULTSStudy Group Chara
- Page 13 and 14: 10more than any other drug also inj
- Page 15 and 16: 12Table 3.5. Reasons for using curr
- Page 17 and 18: 14The next most common eye problem
- Page 19 and 20: 16That’s what I learnt from my ma
- Page 21 and 22: 18s imply re turn to the needle ex
- Page 23 and 24: 20rise in the numbe r o f visits is
- Page 25 and 26: 22proposed to amend the misuse of d
- Page 27 and 28: 24the era of needle/syringe exchang
- Page 29 and 30: 26O live r, K. J., S. R . Friedman,
- Page 31 and 32: APPENDIX B: Structured Questionnair
- Page 33 and 34: US ING THE C ITRIC AC ID S ACHETS22
- Page 35 and 36: 37. In the last 3 months, approxima
- Page 37: APPENDIX D: C itric Acid SachetSour
6CHAPTER 2 METHODOLOGYAims & Objectives<strong>The</strong> study aimed to assess the acceptability, effectiveness and efficiency of the provisionof 100mg single use sachets of citric acid to injecting drug users. <strong>The</strong> objectives were toassess:• If the amount of citric a cid is sufficient to disso lve the amount of he ro in use d pe rinjection.• If the provision of one sachet per one needle/syringe is adequate for the needs ofinjectors.• <strong>The</strong> number of citric burns experienced using the sachets.• If the uptake of needles/syringes from exchanges has increased since theintroduction of the sachets.Project ManagementA working group comprising Avril Taylor (Chair in Public Health, University of Paisley), KayRoberts (Area Pharmacy Specialist – Drug Misuse, Greater Glasgow Primary Care NHST rus t), Da vid Rob inso n (P ro je ct Co -o rd inato r, La narksh ire Ha rm Redu ctio n Team ), BrianRae (Research Manager, Greater Glasgow Primary Care NHS Trust) and Jennifer Garden(Re sea rch <strong>Of</strong>fice r, Sco ttish Cen tre fo r I nfe ctio n an d En vironmen ta l Hea lth) me t re gu la rlyto ratify the proposed interview schedule and methodology.Sampling StrategyTwo pharmacy exchanges in Greater Glasgow, two pharmacy exchanges in Lanarkshireand two fixed site needle exchanges in Lanarkshire agreed to take part in the study. <strong>The</strong>seex cha nges we re invited to pa rticipa te in the pro je ct as the y a re among the busie s t inGreater Glasgow and Lanarkshire and allowed for a large number of injecting drug usersto be approached. Three hundred and sixty injecting drug users who attended theseneedle exchanges were recruited to the study between August and November 2002. <strong>The</strong>provision of the single use citric acid sachets began in Greater Glasgow in December 2001and in Lanarkshire in March 2002. This meant that all the participants would have had theopportunity to use the single use citric acid sachets at the time of being interviewed. Onehundred and twenty participants were from the Lanarkshire NHS Board area and 240 werefrom the Greater Glasgow NHS Board area. This sample represents 10% of all injectorswho attended needle exchanges in Lanarkshire in August 2001 and 5% of all contacts toGlasgow pharmacies per month over the period September 2000 to March 2001 (thenumber of individuals using Glasgow pharmacies is not available).Potential participants were approached after the needle exchange staff had served them.I nte rvie ws we re ca rried o ut the re and the n in a quie t co rne r of the ex change. Ea chinte rvie w took less than ten minutes to comple te a nd wa s comple te ly a nonymous andconfidential. All participants were offered a bar of chocolate and a can of juice for takingthe time to pa rticipate in the s tudy.
Change language