Patient centered medication treatment for opioid use disorder in rural Vermont: a qualitative study
Abstract Background Opioid-related fatal overdoses are occurring at historically high levels and increasing each year. Accessible social and financial support are imperative to the initiation and success of treatment for Opioid Use Disorder (OUD). Medications for Opioid Use Disorder (MOUD) offer eff...
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| Language: | English |
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BMC
2025-01-01
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| Series: | Addiction Science & Clinical Practice |
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| Online Access: | https://doi.org/10.1186/s13722-024-00529-8 |
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| author | Emily G. Hichborn Owen B. Murray Eilis I. Murphy Tess E. Gallant Sarah K. Moore Bethany M. McLeman John Saroyan Anthony Folland Megan Mitchell Lisa A. Marsch |
| author_facet | Emily G. Hichborn Owen B. Murray Eilis I. Murphy Tess E. Gallant Sarah K. Moore Bethany M. McLeman John Saroyan Anthony Folland Megan Mitchell Lisa A. Marsch |
| author_sort | Emily G. Hichborn |
| collection | DOAJ |
| description | Abstract Background Opioid-related fatal overdoses are occurring at historically high levels and increasing each year. Accessible social and financial support are imperative to the initiation and success of treatment for Opioid Use Disorder (OUD). Medications for Opioid Use Disorder (MOUD) offer effective treatment but there are many more people with untreated OUD than receiving evidence-based medication. Patient-centered care is associated with increased care utilization for substance use disorders. This qualitative study explored the patient perspective of OUD care through a Patient-Centered Care (PCC) framework to illuminate patients’ sense of engagement in care. Methods Fifteen semi-structured telephone interviews were conducted from August through November of 2021 regarding patient experiences receiving MOUD in 13 Vermont Hub and Spoke clinics. Emergent themes were deductively mapped to PCC domains of Therapeutic Alliance, Individualized Care, Shared Decision-Making, and Holistic Care. Results Participants indicated that PCC fostered engagement and often characterized MOUD clinics they no longer attended as lacking in PCC. Themes related to Therapeutic Alliance were the most prevalent and suggest pathways to retention. Individualizing care through flexible appointment scheduling was strongly valued, while inflexible scheduling fostered fear of not getting medication. Some participants indicated they were less likely to remain in care when providers did not include them in decisions about medication type, dose, or formulation. Participants also appreciated holistic biopsychosocial care and care referrals. Conclusions Patient-centered MOUD care was important to participants and encouraged engagement in care. Prioritizing alliance with patients, adapting care to patient needs and preferences particularly when scheduling, including patients in medication decisions, and biopsychosocial attention to patients are congruent with patient perception of desirable MOUD care. Having this understanding of an established, leading MOUD treatment system may serve to benefit states looking to implement this model, or for states who are looking to improve the model they already have in place, potentially leading to higher treatment and retention rates. Trial registration This was not a clinical trial involving an intervention, and therefore registration was not required. |
| format | Article |
| id | doaj-art-e3527ccf782d4e2ca82cf3732585cfc2 |
| institution | Kabale University |
| issn | 1940-0640 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Addiction Science & Clinical Practice |
| spelling | doaj-art-e3527ccf782d4e2ca82cf3732585cfc22025-01-19T12:34:19ZengBMCAddiction Science & Clinical Practice1940-06402025-01-0120111010.1186/s13722-024-00529-8Patient centered medication treatment for opioid use disorder in rural Vermont: a qualitative studyEmily G. Hichborn0Owen B. Murray1Eilis I. Murphy2Tess E. Gallant3Sarah K. Moore4Bethany M. McLeman5John Saroyan6Anthony Folland7Megan Mitchell8Lisa A. Marsch9Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth CollegeCenter for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth CollegeCenter for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth CollegeCenter for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth CollegeCenter for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth CollegeCenter for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth CollegeVermont Blueprint for Health, Vermont Agency of Human Services3Vermont Department of Health, Division of Substance Use Programs3Vermont Department of Health, Division of Substance Use ProgramsCenter for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth CollegeAbstract Background Opioid-related fatal overdoses are occurring at historically high levels and increasing each year. Accessible social and financial support are imperative to the initiation and success of treatment for Opioid Use Disorder (OUD). Medications for Opioid Use Disorder (MOUD) offer effective treatment but there are many more people with untreated OUD than receiving evidence-based medication. Patient-centered care is associated with increased care utilization for substance use disorders. This qualitative study explored the patient perspective of OUD care through a Patient-Centered Care (PCC) framework to illuminate patients’ sense of engagement in care. Methods Fifteen semi-structured telephone interviews were conducted from August through November of 2021 regarding patient experiences receiving MOUD in 13 Vermont Hub and Spoke clinics. Emergent themes were deductively mapped to PCC domains of Therapeutic Alliance, Individualized Care, Shared Decision-Making, and Holistic Care. Results Participants indicated that PCC fostered engagement and often characterized MOUD clinics they no longer attended as lacking in PCC. Themes related to Therapeutic Alliance were the most prevalent and suggest pathways to retention. Individualizing care through flexible appointment scheduling was strongly valued, while inflexible scheduling fostered fear of not getting medication. Some participants indicated they were less likely to remain in care when providers did not include them in decisions about medication type, dose, or formulation. Participants also appreciated holistic biopsychosocial care and care referrals. Conclusions Patient-centered MOUD care was important to participants and encouraged engagement in care. Prioritizing alliance with patients, adapting care to patient needs and preferences particularly when scheduling, including patients in medication decisions, and biopsychosocial attention to patients are congruent with patient perception of desirable MOUD care. Having this understanding of an established, leading MOUD treatment system may serve to benefit states looking to implement this model, or for states who are looking to improve the model they already have in place, potentially leading to higher treatment and retention rates. Trial registration This was not a clinical trial involving an intervention, and therefore registration was not required.https://doi.org/10.1186/s13722-024-00529-8Opioid use disorderMedication treatmentPatient perspectiveQualitativePatient-centered care |
| spellingShingle | Emily G. Hichborn Owen B. Murray Eilis I. Murphy Tess E. Gallant Sarah K. Moore Bethany M. McLeman John Saroyan Anthony Folland Megan Mitchell Lisa A. Marsch Patient centered medication treatment for opioid use disorder in rural Vermont: a qualitative study Addiction Science & Clinical Practice Opioid use disorder Medication treatment Patient perspective Qualitative Patient-centered care |
| title | Patient centered medication treatment for opioid use disorder in rural Vermont: a qualitative study |
| title_full | Patient centered medication treatment for opioid use disorder in rural Vermont: a qualitative study |
| title_fullStr | Patient centered medication treatment for opioid use disorder in rural Vermont: a qualitative study |
| title_full_unstemmed | Patient centered medication treatment for opioid use disorder in rural Vermont: a qualitative study |
| title_short | Patient centered medication treatment for opioid use disorder in rural Vermont: a qualitative study |
| title_sort | patient centered medication treatment for opioid use disorder in rural vermont a qualitative study |
| topic | Opioid use disorder Medication treatment Patient perspective Qualitative Patient-centered care |
| url | https://doi.org/10.1186/s13722-024-00529-8 |
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