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Optimizing Patient Engagement in Treatment for Opioid Use Disorder: Primary Care Team Perspectives on Influencing Factors.
Austin, Elizabeth J; Chen, Jessica; Soyer, Elena; Idrisov, Bulat; Briggs, Elsa S; Ferro, Lori; Saxon, Andrew J; Fortney, John C; Curran, Geoffrey M; Moghimi, Yavar; Blanchard, Brittany E; Williams, Emily C; Ratzliff, Anna D; Ruiz, Monica S; Koch, Ulrich.
Afiliación
  • Austin EJ; Department of Health Systems and Population Health, School of Public Health, University of Washington, Box 351621, Seattle, WA, USA. austie@uw.edu.
  • Chen J; Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University, Washington, D.C., USA. austie@uw.edu.
  • Soyer E; Department of Health Systems and Population Health, School of Public Health, University of Washington, Box 351621, Seattle, WA, USA.
  • Idrisov B; Department of Health Systems and Population Health, School of Public Health, University of Washington, Box 351621, Seattle, WA, USA.
  • Briggs ES; Department of Health Systems and Population Health, School of Public Health, University of Washington, Box 351621, Seattle, WA, USA.
  • Ferro L; Department of Health Systems and Population Health, School of Public Health, University of Washington, Box 351621, Seattle, WA, USA.
  • Saxon AJ; Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
  • Fortney JC; Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
  • Curran GM; Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound, Seattle, WA, USA.
  • Moghimi Y; Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
  • Blanchard BE; Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound, Seattle, WA, USA.
  • Williams EC; Advancing Integrated Mental Health Solutions (AIMS) Center, University of Washington, Seattle, WA, USA.
  • Ratzliff AD; Departments of Pharmacy Practice and Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
  • Ruiz MS; Central Arkansas Veterans Health Care System, Little Rock, USA.
  • Koch U; Department of Psychiatry and Behavioral Sciences, School of Medicine and Health Sciences, The George Washington University, Washington, D.C., USA.
J Gen Intern Med ; 2024 Jul 29.
Article en En | MEDLINE | ID: mdl-39073482
ABSTRACT

BACKGROUND:

Opioid use disorder (OUD) care engagement rates in primary care (PC) settings are often low. Little is known about PC team experiences when delivering OUD treatment and potential factors that influence their capacity to engage patients in treatment. Exploring PC team experiences may inform needed supports that can optimize OUD care delivery and improve outcomes for patients with OUD.

OBJECTIVE:

We explored multidisciplinary PC team perspectives on barriers and facilitators to engaging patients in OUD treatment.

DESIGN:

Qualitative study using in-depth interviews.

PARTICIPANTS:

Primary care clinical teams.

APPROACH:

We conducted semi-structured interviews (n = 35) with PC team members involved in OUD care delivery, recruited using a combination of criterion and maximal variation sampling. Data collection and analysis were informed by existing theoretical literature about patient engagement, specifically that patient engagement is influenced by factors across individual (patient, provider), interpersonal (patient-provider), and health system domains. Interviews were professionally transcribed and doubled-coded using a coding schema based on the interview guide while allowing for emergent codes. Coding was iteratively reviewed using a constant comparison approach to identify themes and verified with participants and the full study team. KEY

RESULTS:

Analysis identified five themes that impact PC team ability to engage patients effectively, including limited patient contact (e.g., phone, text) in between visits, varying levels of provider confidence to navigate OUD treatment discussions, structural factors (e.g., schedules, productivity goals) that limited provider time, the role of team-based approaches in lessening discouragement and feelings of burnout, and lack of shared organizational vision for reducing harms from OUD.

CONCLUSIONS:

While the capacity of PC teams to engage patients in OUD care is influenced across multiple levels, some of the most promising opportunities may involve addressing system-level factors that limit PC team time and collaboration and promoting organizational alignment on goals for OUD treatment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Gen Intern Med Asunto de la revista: MEDICINA INTERNA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Gen Intern Med Asunto de la revista: MEDICINA INTERNA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos