TY - JOUR
KW - Adult
KW - Analgesics, Opioid/therapeutic use
KW - Buprenorphine/therapeutic use
KW - Female
KW - Health Services Accessibility
KW - Humans
KW - Male
KW - Methadone/therapeutic use
KW - Middle Aged
KW - Naltrexone/therapeutic use
KW - Opiate Substitution Treatment
KW - Opioid-Related Disorders/drug therapy
KW - Primary Health Care
KW - Young Adult
KW - buprenorphine
KW - opioid use disorder
AU - B. Tofighi
AU - A. R. Williams
AU - C. Chemi
AU - S. Suhail-Sindhu
AU - V. Dickson
AU - J. D. Lee
A1 - 
AB - Introduction: This study explored factors influencing patient access to medications for opioid use disorder (OUD), particularly for individuals eligible but historically suboptimal follow-up with in-house referrals to office-based opioid treatment (OBOT). Objectives: In-depth qualitative interviews among a mostly underserved sample of adults with OUD elicited: 1) knowledge and experiences across the OUD treatment cascade; and 2) more nuanced elements of patient-centered care, including shared decision making with providers, experiences in OBOT versus specialty addiction treatment, transitioning from methadone to buprenorphine or extended-release naltrexone (XR-NTX), and voluntary discontinuation of medications for OUD. Methods: We conducted semi-structured qualitative interviews between January and February of 2018 among adult inpatient detoxification program patients with OUD (n = 23). Preliminary analysis of interviews yielded key themes and ideas that were coded from a grounded theory approach. Results: Willingness to engage with OBOT was influenced by a complex array of practical considerations, including access to patient-centered care in OBOT settings, positive experiences with illicitly obtained buprenorphine, and differential experiences pertaining to OBOT versus specialty addiction treatment. Responses were generally favorable towards OBOT with buprenorphine, yet knowledge regarding extended-release naltrexone was limited. Respondents were often frustrated by clinicians when requesting to transition from methadone to buprenorphine or XR-NTX. Lastly, participants elucidated limited access to OBOT programs in underserved neighborhoods and suburban settings. Conclusion: Limited access to patient-centered care in OBOT with buprenorphine and extended-release naltrexone may exacerbate challenges to retention and/or reengagement with OUD care.
AD - Department of Population Health, New York University School of Medicine, New York, NY, USA.; Division of General Internal Medicine and Clinical Innovation, New York University School of Medicine, New York, NY, USA.; Center for Drug Use and HIV Research, New York, NY, USA.; Columbia University Medical Center, New York, NY, USA.; Department of Population Health, New York University School of Medicine, New York, NY, USA.; Department of Population Health, New York University School of Medicine, New York, NY, USA.; Center for Drug Use and HIV Research, New York, NY, USA.; Department of Psychiatry, New York University School of Medicine, New York, NY, USA.; Department of Population Health, New York University School of Medicine, New York, NY, USA.; Center for Drug Use and HIV Research, New York, NY, USA.; Columbia University Medical Center, New York, NY, USA.
BT - Substance use & misuse
C5 - Opioids & Substance Use; Healthcare Disparities
CP - 14
DO - 10.1080/10826084.2019.1653324
IS - 14
JF - Substance use & misuse
LA - eng
M1 - Journal Article
N2 - Introduction: This study explored factors influencing patient access to medications for opioid use disorder (OUD), particularly for individuals eligible but historically suboptimal follow-up with in-house referrals to office-based opioid treatment (OBOT). Objectives: In-depth qualitative interviews among a mostly underserved sample of adults with OUD elicited: 1) knowledge and experiences across the OUD treatment cascade; and 2) more nuanced elements of patient-centered care, including shared decision making with providers, experiences in OBOT versus specialty addiction treatment, transitioning from methadone to buprenorphine or extended-release naltrexone (XR-NTX), and voluntary discontinuation of medications for OUD. Methods: We conducted semi-structured qualitative interviews between January and February of 2018 among adult inpatient detoxification program patients with OUD (n = 23). Preliminary analysis of interviews yielded key themes and ideas that were coded from a grounded theory approach. Results: Willingness to engage with OBOT was influenced by a complex array of practical considerations, including access to patient-centered care in OBOT settings, positive experiences with illicitly obtained buprenorphine, and differential experiences pertaining to OBOT versus specialty addiction treatment. Responses were generally favorable towards OBOT with buprenorphine, yet knowledge regarding extended-release naltrexone was limited. Respondents were often frustrated by clinicians when requesting to transition from methadone to buprenorphine or XR-NTX. Lastly, participants elucidated limited access to OBOT programs in underserved neighborhoods and suburban settings. Conclusion: Limited access to patient-centered care in OBOT with buprenorphine and extended-release naltrexone may exacerbate challenges to retention and/or reengagement with OUD care.
PY - 2019
SN - 1532-2491; 1082-6084; 1082-6084
SP - 2409
EP - 2419
EP - 
T1 - Patient Barriers and Facilitators to Medications for Opioid Use Disorder in Primary Care
T2 - Substance use & misuse
TI - Patient Barriers and Facilitators to Medications for Opioid Use Disorder in Primary Care
U1 - Opioids & Substance Use; Healthcare Disparities
U2 - 31429351
U3 - 10.1080/10826084.2019.1653324
VL - 54
VO - 1532-2491; 1082-6084; 1082-6084
Y1 - 2019
ER -