Evidence map›Paper›PMID 34798887›Full record

ArticleHarm reduction journal2021

Implementation and first-year operating costs of an academic medical center-based syringe services program.

Tyler S Bartholomew, Hardik Patel, Kathryn McCollister, Daniel J Feaster, Hansel E Tookes

Open access · goldAbstract read
In one paragraph

Article in Harm reduction journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Tyler S BartholomewDepartment of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th St, Miami, FL, 33136, USA. tsb61@miami.edu.ORCID 0000-0002-9384-0812
Hardik PatelDepartment of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA.
Kathryn McCollisterDepartment of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th St, Miami, FL, 33136, USA.
Daniel J FeasterDepartment of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th St, Miami, FL, 33136, USA.
Hansel E TookesDepartment of Infectious Diseases, Miller School of Medicine, University of Miami, Miami, FL, USA.
University of Miami · US

Funding

The Florida Node Alliance of the National Drug Abuse Treatment Clinical Trials NetworkUG1DA013720 · NIDA · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI Daniel J Feaster, Viviana Elizabeth Horigian · 2015 to 2026
$50.6M
Tumor Biology Research ProgramP30CA240139 · NCI · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI George S. Grills · 2019 to 2026
$24.1M
Utilization of health services after engagement with opioid use disorder (OUD) treatment provider by individuals with and without post-traumatic stress disorderP30DA040500 · NIDA · WEILL MEDICAL COLL OF CORNELL UNIV · PI ZACHARY Franklin MEISEL · 2015 to 2026
$20.7M
The University of Miami AIDS Research Center on Mental Health and HIV/AIDS - Center for HIV & Research in Mental Health (CHARM)Research Core & MHD-CEP30MH133399 · NIMH · UNIVERSITY OF MIAMI CORAL GABLES · PI Steven A Safren · 2023 to 2026
$8.9M
A Multi-site Multi-Setting RCT of Integrated HIV Prevention and HCV Care for PWIDR01DA045713 · NIDA · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI BRUNEAU, JULIE, FEASTER, DANIEL J · 2017 to 2022
$8.2M
University of Miami Developmental HIV/AIDS Mental Health Research Center (D-ARC)P30MH116867 · NIMH · UNIVERSITY OF MIAMI CORAL GABLES · PI SAFREN, STEVEN A · 2019 to 2023
$6.5M
Training Program on HIV and Substance Use in the Criminal Justice SystemT32DA037801 · NIDA · COLUMBIA UNIV NEW YORK MORNINGSIDE · PI Nabila El-Bassel, Lisa R Metsch · 2014 to 2026
$5.7M
Tele-Harm Reduction for Rapid Initiation of Antiretrovirals in People who Inject Drugs: a Randomized Controlled TrialDP2DA053720 · NIDA · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI TOOKES, HANSEL EMORY · 2021 to 2024
$2.6M
NCI NIH HHS P30 CA240139NIDA NIH HHS DP2 DA053720NIDA NIH HHS P30 DA040500NIDA NIH HHS R01 DA045713NIDA NIH HHS T32 DA037801NIDA NIH HHS UG1 DA013720NIMH NIH HHS P30 MH116867NIMH NIH HHS P30 MH133399
6 · The paper itself

Abstract

backgroundSyringe services programs (SSPs) remain highly effective, cost-saving interventions for the prevention of blood-borne infections among people who inject drugs. However, there have been restrictions regarding financial resources allocated to these programs, particularly in the US South. This study aimed to provide cost data regarding the implementation and first-year operations of an academic-based SSP utilizing fixed and mobile strategies, including the integration of onsite wound care.

methodsWe conducted a micro-costing study that retrospectively collected detailed resource utilization and unit cost data for both the fixed and mobile SSP strategies, including onsite wound care, from both healthcare and societal perspectives. A three-step approach was used to identify, measure, and value intervention costs, and cost components were categorized into implementation, variable program, and time-dependent costs. Sensitivity analysis was performed to examine the impact of SSP operational changes (i.e., needs-based distribution and opt-out HIV/HCV testing) on the cost-per-participant. Cost data we presented as overall cost and cost-per-participant adjusted to 2017 US dollars.

resultsA total of 452 and 129 participants enrolled in fixed and mobile SSP services, respectively. The total cost associated with implementation and first year operations for the fixed site was $407,217.22 or $729.72 per participant and $311,625.52 or $2415.70 per participant for the mobile unit. The largest cost component for both modalities was time-dependent costs (personnel and overhead), while intervention materials (syringes, injection equipment, naloxone) were less than 15% of the total program cost. DISCUSSION/

conclusionImplementation and operation of new SSP models continue to be low cost compared to treatment for the multitude of harms PWID face without access to evidence-based prevention. Future cost-effectiveness and cost-benefit analyses integrating a comprehensive SSP model within an academic institution, including onsite wound care and other medical services, will provide a more comprehensive understanding of this model, and state-level policy action must be taken to lift the prohibition of state and local funds for the implementation, sustainability, and maintenance of these programs in Florida.

Indexed as

HIV InfectionsSubstance Abuse, IntravenousAcademic Medical CentersHumansNeedle-Exchange ProgramsRetrospective StudiesSyringesCostImplementationSyringe services programs

Identifiers

PMID34798887
PMCPMC8602990
OpenAlexW3212262856

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.