Publications by authors named "Shuchin Shukla"

Objectives: Prehospital buprenorphine administration programs (PBAPs) have spread throughout the United States (U.S.) with limited information on their locations or barriers to implementation, posing challenges to emergency medical services (EMS) systems adopting this clinical care model.

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Introduction: Despite sustained efforts to reduce opioid-related overdose fatalities, rates have continued to rise. In many areas, overdose response involves emergency medical service (EMS) personnel administering naloxone and transporting patients to the emergency department (ED). However, a substantial number of patients decline transport, and many EDs do not provide medication for opioid use disorder (MOUD).

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Article Synopsis
  • - The study investigates the impact of New York State's consent requirement for HIV screening on screening rates, contrasting it with hepatitis C virus (HCV) screening, which does not require consent.
  • - An analysis of 11,938 hospitalized patients in 2015-2016 revealed that 38.5% were screened for HIV compared to 59.1% for HCV, with a significant adjusted risk difference of 22.0% in favor of HCV screening.
  • - The findings indicate that the consent requirement likely hampers routine HIV screening, implying that addressing perceptions and procedural differences between the two screenings is essential for improving public health outcomes related to HIV.
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The New York City Department of Health and Mental Hygiene (DOHMH) implemented Project INSPIRE, an integrated model of hepatitis C care coordination and telementoring services, from 2014 to 2017. We evaluated the use of chronic care management (CCM) codes to sustain the intervention. DOHMH data were collected as part of a Healthcare Innovation Award from the Centers for Medicare & Medicaid Services (CMS).

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Article Synopsis
  • Project INSPIRE provides a telementoring program to help primary care providers treat hepatitis C virus (HCV) by offering them guidance from specialists in an easily accessible format.
  • The program includes weekly sessions that focus on teaching providers how to identify, assess, and treat HCV, improving their confidence in managing these patients.
  • Results showed that participants felt more knowledgeable and satisfied with their ability to treat HCV, fostering a supportive network among providers and enhancing continuity of care for patients.
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Objective: To estimate the cost of delivering a hepatitis C virus care coordination program at 2 New York City health care provider organizations and describe a potential payment model for these currently nonreimbursed services.

Design: An economic evaluation of a hepatitis C care coordination program was conducted using micro-costing methods compared with macro-costing methods. A potential payment model was calculated for 3 phases: enrollment to treatment initiation, treatment initiation to treatment completion, and a bonus payment for laboratory evidence of successful treatment outcome (sustained viral response).

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A 40-year-old woman with HIV (CD4 270, viral load undetectable) from Zambia presented with fevers, urinary tract infection symptoms, sterile pyuria and haematuria. She was found to have genitourinary tuberculosis (TB) via mycobacterial culture of urine and ascites, and treated with rifabutin, isoniazid, pyrazinamide and ethambutol. She later had multiple episodes of asymptomatic transaminitis, triggering changes to both TB and HIV regimens.

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