Wong Grace, Cheng Anna, Cheng Kyle, Masoe Angela, D'Hary Sanjana, Montebello Mark Enea
Primary and Community Health, Oral Health Services, Northern Sydney Local Health District, NSW Health, St Leonards, NSW, Australia; and Sydney Dental School, Faculty of Medicine and Health, the University of Sydney, Sydney, NSW, Australia; and School of Nursing and Midwifery, Western Sydney University, Liverpool, NSW, Australia.
Primary and Community Health, Oral Health Services, Northern Sydney Local Health District, NSW Health, St Leonards, NSW, Australia.
Aust J Prim Health. 2025 Jan;31. doi: 10.1071/PY24134.
Background Despite the paramount importance of oral health, individuals undergoing treatment for opioid use disorder face unique challenges beyond traditional addiction care. This qualitative study explores the challenges Opioid Treatment Program (OTP) clients in Australia encounter when accessing oral health care, aiming to understand the underlying factors and identify effective strategies for integrating oral health into an OTP. Methods Semi-structured interviews were conducted with OTP clients, OTP clinicians and oral health clinicians using tested interview guides. Thematic analysis identified patterns and themes across participants' responses. Results Client behaviour and traits such as inadequate health prioritisation, crisis-driven care and lack of motivation, shaped by a complex social environment, contribute significantly to inconsistent care and neglected oral health. Addiction exacerbates oral health issues as clients prioritise drug use over oral care and financial constraints, resulting in poor oral hygiene and a higher prevalence of dental problems. Psychological barriers such as dental anxiety deter clients from seeking care, while access issues including administrative burdens and system barriers, lost phones and unstable living conditions hinder consistent management of oral health. Stakeholders recommend actionable steps to address OTP clients' challenges, including integrating holistic care, establishing collaborative support systems, improving awareness and education and enhancing accessibility and flexible scheduling. Conclusion This study established a framework for improving OTP clients' oral health through integrated, holistic strategies. By addressing gaps in existing research, it supports the development of public health policies integrating oral health care into OTPs, aiming to foster collaboration, improve access and advance client education for better health outcomes.
背景 尽管口腔健康至关重要，但接受阿片类药物使用障碍治疗的个体面临着超越传统成瘾护理的独特挑战。本定性研究探讨了澳大利亚阿片类药物治疗项目（OTP）的客户在获得口腔医疗服务时遇到的挑战，旨在了解潜在因素，并确定将口腔健康纳入OTP的有效策略。方法 使用经过测试的访谈指南，对OTP客户、OTP临床医生和口腔健康临床医生进行了半结构化访谈。主题分析确定了参与者回答中的模式和主题。结果 客户的行为和特质，如健康优先级不足、危机驱动的护理和缺乏动力，在复杂的社会环境影响下，极大地导致了护理的不一致和口腔健康的被忽视。成瘾加剧了口腔健康问题，因为客户将药物使用置于口腔护理和经济限制之上，导致口腔卫生差和牙科问题的患病率更高。诸如牙科焦虑等心理障碍使客户不愿寻求护理，而包括行政负担和系统障碍、丢失手机和不稳定生活条件等获取问题则阻碍了口腔健康的持续管理。利益相关者建议采取可行的措施来应对OTP客户的挑战，包括整合整体护理、建立协作支持系统、提高认识和教育水平以及增强可及性和灵活安排。结论 本研究建立了一个通过综合、整体策略改善OTP客户口腔健康的框架。通过填补现有研究的空白，它支持制定将口腔医疗保健纳入OTP的公共卫生政策，旨在促进合作、改善获取机会并推进客户教育以实现更好的健康结果。
