TY - JOUR
KW - Buprenorphine/therapeutic use
KW - Humans
KW - Methadone/therapeutic use
KW - Opiate Substitution Treatment
KW - Opioid-Related Disorders/drug therapy
KW - Patient-Centered Care
KW - buprenorphine/naloxone
KW - Canada
KW - health care providers
KW - Methadone
KW - opioid use disorder
KW - patient-centred care
KW - Social Justice
KW - Treatment Outcomes
AU - K. Marshall
AU - G. Maina
AU - J. Sherstobitoff
A1 - 
AB - BACKGROUND: Patients with opioid use disorder (OUD) often have complex health care needs. Methadone is one of the medications for opioid use disorder (MOUD) used in the management of OUDs. Highly restrictive methadone treatment-which requires patient compliance with many rules of care-often results in low retention, especially if there is inadequate support from healthcare providers (HCPs). Nevertheless, HCPs should strive to offer patient-centred care (PCC) as it is deemed the gold standard to care. Such an approach can encourage patients to be actively involved in their care, ultimately increasing retention and yielding positive treatment outcomes. METHODS: In this secondary analysis, we aimed to explore how HCPs were applying the principles of PCC when caring for patients with OUD in a highly restrictive, biomedical and paternalistic setting. We applied Mead and Bower's PCC framework in the secondary analysis of 40 in-depth, semi-structured interviews with both HCPs and patients. RESULTS: We present how PCC's concepts of; (a) biopsychosocial perspective; (b) patient as a person; (c) sharing power and responsibility; (d) therapeutic alliance and (e) doctor as a person-are applied in a methadone treatment program. We identified both opportunities and barriers to providing PCC in these settings. CONCLUSION: In a highly restrictive methadone treatment program, full implementation of PCC is not possible. However, implementation of some aspects of PCC are possible to improve patient empowerment and engagement with care, possibly leading to increase in retention and better treatment outcomes.
AD - University of Saskatchewan, Saskatoon, Canada.; University of Saskatchewan, Saskatoon, Canada. geoffrey.maina@usask.ca.; Selkirk College, Castlegar, Canada.
BT - Addiction science & clinical practice
C5 - Education & Workforce; Opioids & Substance Use
CP - 1
DO - 10.1186/s13722-021-00251-9
IS - 1
JF - Addiction science & clinical practice
LA - eng
M1 - Journal Article
N2 - BACKGROUND: Patients with opioid use disorder (OUD) often have complex health care needs. Methadone is one of the medications for opioid use disorder (MOUD) used in the management of OUDs. Highly restrictive methadone treatment-which requires patient compliance with many rules of care-often results in low retention, especially if there is inadequate support from healthcare providers (HCPs). Nevertheless, HCPs should strive to offer patient-centred care (PCC) as it is deemed the gold standard to care. Such an approach can encourage patients to be actively involved in their care, ultimately increasing retention and yielding positive treatment outcomes. METHODS: In this secondary analysis, we aimed to explore how HCPs were applying the principles of PCC when caring for patients with OUD in a highly restrictive, biomedical and paternalistic setting. We applied Mead and Bower's PCC framework in the secondary analysis of 40 in-depth, semi-structured interviews with both HCPs and patients. RESULTS: We present how PCC's concepts of; (a) biopsychosocial perspective; (b) patient as a person; (c) sharing power and responsibility; (d) therapeutic alliance and (e) doctor as a person-are applied in a methadone treatment program. We identified both opportunities and barriers to providing PCC in these settings. CONCLUSION: In a highly restrictive methadone treatment program, full implementation of PCC is not possible. However, implementation of some aspects of PCC are possible to improve patient empowerment and engagement with care, possibly leading to increase in retention and better treatment outcomes.
PY - 2021
SN - 1940-0640; 1940-0632; 1940-0632
SP - 42
T1 - Plausibility of patient-centred care in high-intensity methadone treatment: reflections of providers and patients
T2 - Addiction science & clinical practice
TI - Plausibility of patient-centred care in high-intensity methadone treatment: reflections of providers and patients
U1 - Education & Workforce; Opioids & Substance Use
U2 - 34187549
U3 - 10.1186/s13722-021-00251-9
VL - 16
VO - 1940-0640; 1940-0632; 1940-0632
Y1 - 2021
Y2 - Jun 29
ER -