Centre for Health Evaluation & Outcome Sciences, Providence Health Care, St. Paul's Hospital, Vancouver, BC, V6Z 1Y6, Canada (HP, KM, SB, DG, MTS, EOJ); School of Population and Public Health, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada (HP, KM, SB, MTS, EOJ); Providence Health Care, Providence Crosstown Clinic, Vancouver, BC V6B 1G6, Canada (SH, SM); Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC H2X 0A9, Canada (SB); Northern Ontario School of Medicine, Sudbury, ON P3E 2C6, Canada (DCM) and Canadian Addiction Treatment Centres, Markham, Ontario L3T 7P6 (DCM).
J Addict Med. 2020 Dec;14(6):480-488. doi: 10.1097/ADM.0000000000000631.
Patient ratings of physician communication in the setting of daily injectable opioid agonist treatment are reported. Associations between communication items and demographic, health, drug use, and treatment characteristics are explored.
Participants (n = 121) were patients receiving treatment for opioid use disorder with hydromorphone (an opioid analgesic) or diacetylmorphine (medical grade heroin). Ratings of physician communication were collected using the 14-item Communication Assessment Tool. Items were dichotomized and associations were explored using univariate and multivariable logistic regression models for each of the 14 items.
Ratings of physician communication were lower than reported in other populations. In nearly all of the 14 multivariable models, participants with more physical health problems and with lower scores for treatment drug liking had lower odds of rating physician communication as excellent.
In physician interactions with patients with opioid use disorder, there is a critical need to address comorbid physical health problems and account for patient medication preferences.
Findings reinforce the role physicians can play in communicating with patients about their comorbid conditions and about medication preferences. In the patient-physician interaction efforts to meet patients' evolving treatment needs and preferences can be made by offering patients access to all available evidence-based treatments.
报告在每日注射阿片类激动剂治疗环境下患者对医生沟通的评分。探讨沟通项目与人口统计学、健康、药物使用和治疗特征之间的关系。
参与者（n=121）为接受氢吗啡酮（一种阿片类镇痛药）或二乙酰吗啡（医用海洛因）治疗药物使用障碍的患者。使用 14 项沟通评估工具收集医生沟通评分。将项目分为二项式，并使用单变量和多变量逻辑回归模型对每个 14 项进行探索。
医生沟通评分低于其他人群的报告。在几乎所有 14 项多变量模型中，身体有更多健康问题和治疗药物喜好评分较低的参与者，将医生沟通评为优秀的可能性较小。
在与阿片类药物使用障碍患者的医生互动中，迫切需要解决合并的身体健康问题，并考虑患者的药物偏好。
研究结果强调了医生在与患者就其合并症和药物偏好进行沟通方面可以发挥的作用。在医患互动中，为患者提供获得所有现有循证治疗的机会，可以满足患者不断变化的治疗需求和偏好。
