Anyanwu Precious, Olateju Olajumoke A, Tata Vaishnavi, Varisco Tyler, Gilbert Lauren R, Ogunsanya Motolani E, Essien E James, Johnson Michael L, Thornton J Douglas
Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Health 2 Building, 4349 Martin Luther King Boulevard, Houston, TX, 77204-5047, USA.
Prescription Drug Misuse and Education Research (PREMIER) Center, University of Houston College of Pharmacy, Health 2 Building, 4349 Martin Luther King Boulevard, Houston, TX, 77204-5047, USA.
Harm Reduct J. 2024 Dec 20;21(1):220. doi: 10.1186/s12954-024-01133-4.
Despite the established effectiveness and relatively widespread availability of Medications for Opioid Use Disorder, individuals seeking treatment frequently encounter various structural and social barriers, including costs of treatment. This study aimed to understand the financial barriers that affect treatment continuation in individuals with opioid use disorder (OUD).
In this qualitative study, seven semi-structured in-depth focus group interviews were conducted among 28 participants in treatment for OUD. Basic demographic information were collected in a pre-focus group survey. Focus group interviews were conducted from December 2021 to February 2022. A moderator guide was used to facilitate the discussion. Transcripts were managed using ATLAS.ti© v7. Data collected from the focus groups underwent deductive thematic analysis.
Data saturation was reached in 7 focus groups with a total of 28 participants (17 [60.7%] women; 27 [96.4%] white; 24 [85.7%] non-Hispanic). All three medications for OUD were represented (18 [64.3%] buprenorphine and naloxone, 5 [17.9%] methadone, 3 [10.7%] naltrexone, and 2 [7.1%] buprenorphine) and the time in treatment ranged from 1 month to over 36 months. Nearly all participants (27 [96.4%]) indicated a financial barrier that led to delayed treatment initiation and treatment retention. Two themes were identified from the focus group interviews: (1) OUD treatment-related financial burden- the direct and indirect cost associated with the treatment, and (2) psychosocial effects associated with the cost of OUD treatment -the mental, emotional, and social effects of the disease.
Most participants described the desire and need for resources to offset the unaffordable cost that inhibits treatment initiation and retention. Further work is required to help identify individuals susceptible to financial barriers that can lead to early discontinuation in treatment.
尽管用于治疗阿片类物质使用障碍的药物已证实有效且相对广泛可得，但寻求治疗的个体经常遇到各种结构和社会障碍，包括治疗费用。本研究旨在了解影响阿片类物质使用障碍（OUD）患者治疗持续的经济障碍。
在这项定性研究中，对28名接受OUD治疗的参与者进行了7次半结构化深度焦点小组访谈。在焦点小组访谈前的调查中收集了基本人口统计学信息。焦点小组访谈于2021年12月至2022年2月进行。使用主持人指南来促进讨论。访谈记录使用ATLAS.ti© v7进行管理。从焦点小组收集的数据进行了演绎主题分析。
7个焦点小组共28名参与者（17名[60.7%]女性；27名[96.4%]白人；24名[85.7%]非西班牙裔）达到了数据饱和。所有三种用于OUD的药物均有代表（18名[64.3%]使用丁丙诺啡和纳洛酮，5名[17.9%]使用美沙酮，3名[10.7%]使用纳曲酮，2名[7.1%]使用丁丙诺啡），治疗时间从1个月到超过36个月不等。几乎所有参与者（27名[96.4%]）表示存在经济障碍，导致治疗开始延迟和治疗中断。从焦点小组访谈中确定了两个主题：（1）与OUD治疗相关的经济负担——与治疗相关的直接和间接成本，以及（2）与OUD治疗费用相关的心理社会影响——该疾病的心理、情感和社会影响。
大多数参与者表示希望并需要资源来抵消抑制治疗开始和持续的难以承受的费用。需要进一步开展工作，以帮助识别易受导致治疗早期中断的经济障碍影响的个体。
