Qualitative Exploration of Emergency Department Care Experiences Among People With Opioid Use Disorder.

Autor: Galarneau LR; George Spady Society, Edmonton, Alberta; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia. Electronic address: lexis@ualberta.ca., Scheuermeyer FX; Department of Emergency Medicine, St Paul's Hospital and University of British Columbia, Vancouver, British Columbia; Center for Health Evaluation and Outcome Sciences, Vancouver, British Columbia., Hilburt J; Vancouver Coastal Health, Vancouver, British Columbia., O'Neill ZR; Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec., Barbic S; Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia; Providence Health Research, Vancouver, British Columbia., Moe J; Department of Emergency Medicine, University of British Columbia, and Vancouver General Hospital and British Columbia Children's Hospital, Vancouver, British Columbia; British Columbia Centre for Disease Control, Vancouver, British Columbia., Buxton JA; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia; British Columbia Centre for Disease Control, Vancouver, British Columbia., Orkin AM; Department of Family and Community Medicine, University of Toronto, and Inner City Health Associates, Toronto, Ontario., Kaczorowski J; Department of Family and Emergency Medicine, University of Montréal, and Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec., Dong K; Department of Emergency Medicine, University of Alberta, Edmonton, Alberta., Tobin D; Vancouver Area Network of Drug Users, Vancouver, British Columbia, Canada., Miles I; Department of Emergency Medicine, St Paul's Hospital and University of British Columbia, Vancouver, British Columbia., Bath M; Vancouver Coastal Health, Vancouver, British Columbia., Grier S; Portland Hotel Society Community Services Society, Vancouver, British Columbia, Canada., Garrod E; Providence Health Care, Vancouver, British Columbia, Canada; British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada., Kestler A; Department of Emergency Medicine, St Paul's Hospital and University of British Columbia, Vancouver, British Columbia; Center for Health Evaluation and Outcome Sciences, Vancouver, British Columbia; British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada.
Jazyk: angličtina
Zdroj: Annals of emergency medicine [Ann Emerg Med] 2023 Jul; Vol. 82 (1), pp. 1-10. Date of Electronic Publication: 2023 Mar 25.
DOI: 10.1016/j.annemergmed.2023.02.007
Abstrakt: Study Objective: We described the experiences and preferences of people with opioid use disorder who access emergency department (ED) services regarding ED care and ED-based interventions.
Methods: Between June and September 2020, we conducted phone or in-person semistructured qualitative interviews with patients recently discharged from 2 urban EDs in Vancouver, BC, Canada, to explore experiences and preferences of ED care and ED-based opioid use disorder interventions. We recruited participants from a cohort of adults with opioid use disorder who were participating in an ED-initiated outreach program. We transcribed audio recordings verbatim. We iteratively developed a thematic coding structure, with interim analyses to assess for thematic saturation. Two team members with lived experience of opioid use provided feedback on content, wording, and analysis throughout the study.
Results: We interviewed 19 participants. Participants felt discriminated against for their drug use, which led to poorer perceived health care and downstream ED avoidance. Participants desired to be treated like ED patients who do not use drugs and to be more involved in their ED care. Participants nevertheless felt comfortable discussing their substance use with ED staff and valued continuous ED operating hours. Regarding opioid use disorder treatment, participants supported ED-based buprenorphine/naloxone programs but also suggested additional options (eg, different initiation regimens and settings and other opioid agonist therapies) to facilitate further treatment uptake.
Conclusion: Based on participant experiences, we recommend addressing potentially stigmatizing practices, increasing patient involvement in their care during ED visits, and increasing access to various opioid use disorder-related treatments and community support.
(Copyright © 2023 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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