Department of Family Medicine, School of Medicine, Faculty of Health Sciences, University of Pretoria, Tshwane.
Afr J Prim Health Care Fam Med. 2023 Jan 30;15(1):e1-e10. doi: 10.4102/phcfm.v15i1.3392.
Opioid substitution therapy (OST) is evidence-based treatment for opioid use disorders and, when taken as maintenance therapy, has proven health and social benefits. The benefits of OST are achieved through the retention of service users in the treatment programme.
To identify factors that affected retention of service users who had OST interrupted in less than 6 months of being in an OST programme.
This qualitative study was conducted with 19 service users from eight Community-Oriented Substance Use Programme (COSUP) sites in the City of Tshwane, Gauteng, South Africa.
Participants were COSUP service users who had interrupted OST in less than 6 months since initiation and were purposefully selected from all COSUP sites. Demographic information was obtained and four focus group discussions covered challenges of OST retention. Discussions were recorded, transcribed and qualitatively analysed using Attride-Stirling's thematic networks framework.
The 19 participants were all male, mostly black African, with a mean age of 26 years. Facilitators of retention in OST were individual readiness to change OST accessibility, positive family and peer support, treatment monitoring, understanding and managing expectations of service users, contribution in society and meaningful opportunities for engagement. Barriers were the cost of OST, bureaucracy within the programme, inability to communicate challenges timeously and effectively to treatment providers, boredom, cravings and poverty.
Opioid substitution therapy programmes can ensure a holistic approach to prevent and treat harms related to illicit opioid use if they remain person-centred and are well-funded.Contribution: Understanding the barriers to, and facilitators of retention on OST can contribute to improved community-based service delivery.
阿片类物质替代疗法（OST）是治疗阿片类药物使用障碍的循证疗法，作为维持治疗，已被证明具有健康和社会效益。OST 的益处是通过让服务使用者保留在治疗计划中实现的。
确定影响在 OST 计划中少于 6 个月中断 OST 的服务使用者保留的因素。
本定性研究在南非豪登省茨瓦内市的 8 个社区导向物质使用计划（COSUP）站点招募了 19 名服务使用者。
参与者是 COSUP 的服务使用者，他们在开始 OST 后不到 6 个月就中断了 OST，并从所有 COSUP 站点中选择了具有代表性的服务使用者。收集了人口统计学信息，并进行了 4 次焦点小组讨论，涵盖了 OST 保留的挑战。讨论被记录、转录并使用 Attride-Stirling 的主题网络框架进行定性分析。
19 名参与者均为男性，大多数为黑人，平均年龄为 26 岁。OST 保留的促进因素包括个人改变 OST 可及性的准备情况、积极的家庭和同伴支持、治疗监测、理解和管理服务使用者的期望、对社会的贡献和有意义的参与机会。障碍包括 OST 的费用、项目中的官僚主义、无法及时有效地与治疗提供者沟通挑战、无聊、渴望和贫困。
如果阿片类物质替代疗法项目保持以个人为中心并得到充分资金，它们可以确保采取整体方法来预防和治疗与非法阿片类药物使用相关的危害。
了解 OST 保留的障碍和促进因素有助于改善基于社区的服务提供。
