From the Division of General Internal Medicine, Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT (MAI, DC); Program for Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA) University of Utah School of Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT (MAI, LS, AJG); Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, UT (PG, ERK, SZ, AJG); Division of Epidemiology, Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT (PG, ERK, SZ); Vulnerable Veteran Innovative PACT (VIP) Initiative, VA Salt Lake City Health Care System, Salt Lake City, UT (AJG).
J Addict Med. 2023;17(4):401-406. doi: 10.1097/ADM.0000000000001140. Epub 2023 Jan 25.
Despite substantial investment in expanding access to treatment for opioid use disorder (OUD), overdose deaths continue to increase. Primary care holds enormous potential to expand access to OUD treatment, but few patients receive medications for OUD (MOUD) in primary care. Understanding both patient and clinician experiences is critical to expanding access to patient-centered MOUD care, yet relatively little research has examined patient perspectives on primary care-based MOUD. We sought to examine the care experiences of patients with OUD receiving medication-based treatment in a primary care setting.
We conducted semistructured interviews with patients receiving MOUD at a single primary care site at the University of Utah. Interviews were performed and transcribed by qualitative researchers, who used rapid qualitative analysis using a grounded theory-based approach to identify key themes pertaining to patient experiences receiving medication-based OUD treatment in primary care.
Twenty-one patients were screened, and 14 completed the interview. In general, participants had numerous medical and psychiatric comorbidities. The following key themes pertaining to primary care-based OUD treatment were identified: (1) overall health improvement, (2) team-based care, (3) comparing primary care to specialty addiction treatment, (4) access to medications for OUD, and (5) discrimination and stigma.
Patients reported many advantages to receiving primary care-based MOUD treatment. In particular, the flexibility and added support of team-based care along with the convenience of receiving addiction treatment alongside regular medical care were highly valued. These findings can be used to develop patient-centered initiatives aimed at expanding OUD treatment within primary care.
尽管在扩大阿片类药物使用障碍(OUD)治疗的可及性方面投入了大量资金,但过量死亡人数仍在继续增加。初级保健在扩大 OUD 治疗的可及性方面具有巨大潜力,但很少有患者在初级保健中接受 OUD 药物治疗(MOUD)。了解患者和临床医生的经验对于扩大以患者为中心的 MOUD 护理至关重要,但相对较少的研究调查了患者对基于初级保健的 MOUD 的看法。我们旨在研究在犹他大学的一个初级保健场所接受基于药物治疗的 OUD 患者的护理体验。
我们对在犹他大学的一个初级保健场所接受 MOUD 的患者进行了半结构化访谈。访谈由定性研究人员进行并转录,他们使用基于扎根理论的快速定性分析方法来确定与患者在初级保健中接受基于药物的 OUD 治疗的体验相关的主要主题。
共有 21 名患者接受了筛选,其中 14 名完成了访谈。一般来说,参与者有许多医疗和精神共病。确定了与基于初级保健的 OUD 治疗相关的以下主要主题:(1)整体健康改善,(2)团队合作,(3)将初级保健与专业成瘾治疗进行比较,(4)获得 OUD 药物,以及(5)歧视和耻辱。
患者报告说,接受基于初级保健的 MOUD 治疗有许多优势。特别是,团队合作的灵活性和额外支持以及在常规医疗保健的同时接受成瘾治疗的便利性受到高度重视。这些发现可用于制定以患者为中心的倡议,旨在扩大初级保健中的 OUD 治疗。