Loma Linda University, School of Behavioral Health, Griggs Hall, 11065 Campus St, Loma Linda, CA 92350, USA.
European AIDS Treatment Group, Av. des Arts 56, Bruxelles 1000, Belgium.
Drug Alcohol Depend. 2024 Feb 1;255:111069. doi: 10.1016/j.drugalcdep.2023.111069. Epub 2023 Dec 26.
Opioid Agonist Treatment (OAT) combines opioid agonist medications with counseling and therapy for a whole-patient approach to treating opioid use disorder. The war in Ukraine threatened the continuity of care and well-being of individuals receiving OAT. This study aimed to capture patients' experiences accessing OAT during the war in Ukraine to provide insights that can inform and improve the programs that serve them.
In October - November 2022, we conducted semi-structured interviews with 17 OAT patients who are peer advocates in the Ukrainian Patient Network VOLNA. All interviews were conducted virtually via Zoom, recorded, and transcribed. Through thematic analysis, we generated codes from the transcripts, iteratively using both inductive and deductive approaches.
The qualitative interviews revealed four themes: 1) 'medication,' focusing on concerns about availability, dosage, and quality of OAT; 2) 'patient barriers,' discussing access challenges for specific patient groups, such as refugees or patients living under the occupation; 3) 'clinic-level challenges,' involving dosing adequacy, treatment continuity, patient volume, and clinician stigma, and 4) 'regulatory inflexibility,' describing uneven implementation of regulations and increased policing to receive OAT during the war.
Our study emphasizes the importance of adapting OAT programs in Ukraine to better serve vulnerable patients affected by the war. The Russian invasion has severely disrupted OAT provision, increasing the risks of opioid withdrawal, overdose, and diversion. By understanding patients' experiences, treatment preferences, and barriers to care, OAT programs can provide continuity of care to those in need.
阿片类激动剂治疗（OAT）将阿片类激动剂药物与咨询和治疗相结合，为治疗阿片类药物使用障碍提供整体患者方法。乌克兰战争威胁到接受 OAT 治疗的个人的护理连续性和幸福感。本研究旨在了解患者在乌克兰战争期间接受 OAT 的体验，为为他们服务的项目提供信息并加以改进。
2022 年 10 月至 11 月，我们对乌克兰患者网络 VOLNA 的 17 名 OAT 患者进行了半结构化访谈。所有访谈均通过 Zoom 虚拟进行，录音并转录。通过主题分析，我们从转录本中生成代码，使用归纳和演绎方法迭代进行。
定性访谈揭示了四个主题：1）“药物”，关注 OAT 的可用性、剂量和质量问题；2）“患者障碍”，讨论了特定患者群体（如难民或受占领影响的患者）的获取挑战；3）“诊所层面的挑战”，涉及剂量充足性、治疗连续性、患者数量和临床医生耻辱感；4）“监管缺乏灵活性”，描述了战争期间 OAT 监管实施的不平衡和执法力度的增加。
我们的研究强调了调整乌克兰 OAT 计划以更好地为受战争影响的脆弱患者服务的重要性。俄罗斯的入侵严重扰乱了 OAT 的供应，增加了阿片类药物戒断、过量和转移的风险。通过了解患者的体验、治疗偏好和护理障碍，OAT 计划可以为有需要的人提供连续性的护理。
