Perspectives About Emergency Department Care Encounters Among Adults With Opioid Use Disorder
| Autor: | Kathryn, Hawk, Ryan, McCormack, E Jennifer, Edelman, Edouard, Coupet, Nicolle, Toledo, Phoebe, Gauthier, John, Rotrosen, Marek, Chawarski, Shara, Martel, Patricia, Owens, Michael V, Pantalon, Patrick, O'Connor, Lauren K, Whiteside, Ethan, Cowan, Lynne D, Richardson, Michael S, Lyons, Richard, Rothman, Lisa, Marsch, David A, Fiellin, Gail, D'Onofrio |
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| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | JAMA Network Open |
| ISSN: | 2574-3805 |
| Popis: | This qualitative study assesses the experiences and perspectives of individuals with untreated opioid use disorder seen in emergency departments (EDs) in 5 regions of the US. Key Points Question What are the experiences and perspectives regarding emergency department (ED) care among US patients with untreated opioid use disorder (OUD) seen in the ED? Findings In this qualitative study of 31 individuals with untreated OUD who were seen in the ED and participated in 6 focus groups, participants described stigma, minimization of pain and medical problems, and a need for access to on-demand OUD treatment with referral and ED staff training. Meaning The findings suggest that the ability of ED staff to engage patients with OUD may be improved by implementing training on stigma reduction and evidence-based practices to enhance care for these patients. Importance Emergency departments (EDs) are increasingly initiating treatment for patients with untreated opioid use disorder (OUD) and linking them to ongoing addiction care. To our knowledge, patient perspectives related to their ED visit have not been characterized and may influence their access to and interest in OUD treatment. Objective To assess the experiences and perspectives regarding ED-initiated health care and OUD treatment among US patients with untreated OUD seen in the ED. Design, Setting, and Participants This qualitative study, conducted as part of 2 studies (Project ED Health and ED-CONNECT), included individuals with untreated OUD who were recruited during an ED visit in EDs at 4 urban academic centers, 1 public safety net hospital, and 1 rural critical access hospital in 5 disparate US regions. Focus groups were conducted between June 2018 and January 2019. Main Outcomes and Measures Data collection and thematic analysis were grounded in the Promoting Action on Research Implementation in Health Services (PARIHS) implementation science framework with evidence (perspectives on ED care), context (ED), and facilitation (what is needed to promote change) elements. Results A total of 31 individuals (mean [SD] age, 43.4 [11.0] years) participated in 6 focus groups. Twenty participants (64.5%) identified as male and most 13 (41.9%) as White; 17 (54.8%) reported being unemployed. Themes related to evidence included patients’ experience of stigma and perceived minimization of their pain and medical problems by ED staff. Themes about context included the ED not being seen as a source of OUD treatment initiation and patient readiness to initiate treatment being multifaceted, time sensitive, and related to internal and external patient factors. Themes related to facilitation of improved care of patients with OUD seen in the ED included a need for on-demand treatment and ED staff training. Conclusions and Relevance In this qualitative study, patients with OUD reported feeling stigmatized and minimized when accessing care in the ED and identified several opportunities to improve care. The findings suggest that strategies to address stigma, acknowledge and treat pain, and provide ED staff training should be implemented to improve ED care for patients with OUD and enhance access to life-saving treatment. |
| Databáze: | OpenAIRE |
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