"Come try it out. Get your foot in the door:" Exploring patient perspectives on low-barrier treatment for opioid use disorder.

Autor: Lowenstein M; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States; Center for Addiction Medicine and Policy, University of Pennsylvania, Philadelphia, PA, United States; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States. Electronic address: margaw@pennmedicine.upenn.edu., Abrams MP; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States., Crowe M; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States., Shimamoto K; Rowan University School of Medicine, Camden, NJ, United States., Mazzella S; Prevention Point Philadelphia, Philadelphia, PA, United States., Botcheos D; Prevention Point Philadelphia, Philadelphia, PA, United States., Bertocchi J; Prevention Point Philadelphia, Philadelphia, PA, United States., Westfahl S; Prevention Point Philadelphia, Philadelphia, PA, United States., Chertok J; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States., Garcia KP; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States., Truchil R; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States., Holliday-Davis M; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States., Aronowitz S; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States; University of Pennsylvania School of Nursing, Philadelphia, PA, United States.
Jazyk: angličtina
Zdroj: Drug and alcohol dependence [Drug Alcohol Depend] 2023 Jul 01; Vol. 248, pp. 109915. Date of Electronic Publication: 2023 May 09.
DOI: 10.1016/j.drugalcdep.2023.109915
Abstrakt: Purpose: Low-barrier treatment is an emerging strategy for opioid use disorder (OUD) care that prioritizes access to evidence-based medication while minimizing requirements that may limit treatment access in more traditional delivery models, particularly for marginalized patients. Our objective was to explore patient perspectives about low-barrier approaches, with a focus on understanding barriers to and facilitators of engagement from the patient point of view.
Methods: We conducted semi-structured interviews with patients accessing buprenorphine treatment from a multi-site, low-barrier mobile treatment program in Philadelphia, PA from July-December 2021. We analyzed interview data using thematic content analysis and identified key themes.
Results: The 36 participants were 58% male, 64% Black, 28% White, and 31% Latinx. 89% were enrolled in Medicaid, and 47% were unstably housed. Our analysis revealed three main facilitators of treatment in the low-barrier model. These included 1) program structure that met participant needs, such as flexibility, rapid medication access and robust case management services; 2) harm reduction approach that included acceptance of patient goals other than abstinence and provision of harm reduction services on-site; and 3) strong interpersonal connections with team members, including those with lived experience. Participants contrasted these experiences with other care they had received in the past. Barriers related to lack of structure, limitations of street-based care, and limited support for co-occurring needs, particularly mental health.
Conclusions: This study provides key patient perspectives on low-barrier approaches for OUD treatment. Our findings can inform future program design to increase treatment access and engagement for individuals poorly served by traditional delivery models.
Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to declare.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: