Nutrition Care Processes Can Improve the Nutritional Status and Quality of Life of Persons Who Use Drugs (PWUDs)

: Addiction affects the economy of countries worldwide. Nutrition plays an important role in helping persons who use drugs (PWUDs) to regain their physical and mental health, thereby increasing the probability of recovery. This study aimed to evaluate the effects of implementing the nutrition care process on PWUDs management 120 days after its implementation. Following a quasi-experimental design with pre and post-test evaluations, 268 PWUDs admitted to 8 drug treatment, and rehabilitation centers in the Philippines were recruited. Developed nutrition management guidelines containing the nutrition care process and cycle menu of calculated diet for PWUDs were provided for implementation in the rehabilitation regimen. Body mass index was used to assess nutritional status, dietary diversity score (DDS) to measure diet quality, WHO quality of life-BREF to assess the quality of life (QoL), Kessler-10 Psychological Distress Scale to determine psychological distress, and Beck’s depression inventory to assess stress level. The results indicated a 92% reduction in underweight during the study period. Participants with high DDS significantly increased from 38.43 to 91.04%. All domains of the QoL were improved, the level of severe depression was significantly decreased (6.72 to 4.48%), and decrease in the proportion of participants experiencing moderate (18.3 to 12.7%) and severe psychological distress (4.48 to 3.73%) was observed. There was no significant association between DDS and the three psychological parameters. The implementation of the nutrition care process and the recovery diets is feasible and could improve the nutritional status, QoL, and stress level of PWUDs.

Validation of Texas Cristian University Psychosocial Functioning and Motivation scales in Iranian Persons who use drugs

Background: Texas Cristian University (TCU) psychosocial functioning and motivation scales were translated and validated for the persons who use drugs (PWUDs). Methods: This study was carried out as a methodological research. The scales were translated forward and backward and then, the PWUDs in Kermanshah-based (west of Iran) substance abuse treatment centers in 2019 filled out the scales. Participants included 250 individuals who were selected by convenience sampling method. A demographics form and psychosocial functioning and motivation scales were used to collect data. For data analysis, content validity, face validity, test-retest, internal consistency, and construct validity were applied by using exploratory analysis methods in SPSS (v.20) and confirmatory factor analysis in LISREL software. Results: Exploratory Factor analysis (EFA) results were obtained by using main component analysis and Varimax rotation of three factors (psychological function, social function, treatment motivation). Extracted factors along with the eigenvalues, attributed variance percentage, and cumulative attributed variances by each factor, by 68.56%, showed a total variance of the questionnaire. Moreover, the fitness indexes of the confirmatory factor analysis (CFA) of psychological function, social function, and treatment motivation were 0.059, 0.075 and 0.072, respectively. Therefore, the questionnaire fitness was at the acceptable level. The test-retest reliability coefficient was 0.875, and the Cronbach's alpha coefficient for all the components was higher than 0.71. + The results showed that psychosocial functioning, motivation scales have good psychometric properties, and they can be used in research and treatment fields.

39. Comparative One-year Outcomes of Invasive staphylococcus Aureus infections Among Persons with and Without Drug Use in an Urban West Coast Cohort

Background Persons who use drugs (PWUD) face substantial risk from invasive Staphylococcus aureus infections but have important demographic and clinical differences from persons without drug use (non-PWUD). Despite this, limited data exist comparing S. aureus infection outcomes in PWUD vs. non-PWUD; these data are needed to inform interventions to optimize care for this vulnerable population. Methods We identified adults hospitalized from 2013–2018 at two academic hospitals in San Francisco with S. aureus bacteremia or ICD-coded diagnoses of endocarditis, epidural abscess, or vertebral osteomyelitis with compatible S. aureus culture. Via structured chart review, we compared the following among PWUD vs. non-PWUD: clinical and substance use features, adjusted odds of antibiotic completion, and one-year infection-free survival using a multivariate Cox proportional hazards model adjusted for age/race, housing, comorbidities, and MRSA. Results Of 963 hospitalizations for invasive S. aureus infections in 946 patients, 372/963 (39%) occurred in PWUD. Among PWUD, heroin (198/372, 53%) and methamphetamine use (185/372, 50%) were common (Table 1). Bacteremia occurred in 82% of hospitalizations. PWUD vs. non-PWUD had higher proportions of MRSA (48% vs. 31%) and invasive infections: 20% vs. 12% with endocarditis, 25% vs. 11% with epidural abscess, and 28% vs. 13% with vertebral osteomyelitis (all p< 0.001). PWUD had more self-directed (“AMA”) discharges, and most using opioids did not receive methadone or buprenorphine (Table 2). PWUD completed antibiotic courses less often (70% vs. 87%; p< 0.001) and had 2.9-fold higher adjusted odds of incomplete treatment (95% CI:1.7–5.0). One-year mortality was lower in PWUD (18% vs. 30%), but one-year readmission for ongoing/recurrent infection was far higher (28% vs. 14%; HR 1.9 [95% CI:1.3–2.9], Figure 1). Table 1: Demographic, Clinical, and Substance Use Characteristics Table 2: Care Delivery, PWUD vs. non-PWUD Figure 1: One-year Infection-free survival in persons who use drugs (PWUD) vs. non-PWUD Conclusion PWUD had higher proportions of S. aureus vertebral osteomyelitis, epidural abscess, and endocarditis than non-PWUD, lower odds of treatment completion, and greater risk of infection persistence/recurrence at one year. Among PWUD, opioid and stimulant use were common and undertreated. New patient centered models of care that deliver synchronized S. aureus infection and substance use disorder therapy are urgently needed. Disclosures All Authors: No reported disclosures