Enhancing Treatment Access and Effectiveness: Toward Patient-Centered Models of Care

Fox, Aaron D.; Jakubowski, Andrea; Giftos, Jonathan

doi:10.1007/978-3-030-16257-3_10

Cited by 2 publications

(7 citation statements)

References 107 publications

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“…Comprehensive assessment of the patient’s condition and treatment preferences at enrollment to the methadone treatment program allows for planning and mapping wraparound services that are important to the patient [ 27 ]. The information gathered during the initial assessment could provide an opportunity for HCPs to anticipate the patients’ recovery trajectory and collaboratively plan ways to care and support the patient in their recovery.…”

Section: Discussionmentioning

confidence: 99%

“…This concept also influences the way HCPs relate with patients and their ability to empathize with the patients' condition. Irrespective of the methadone treatment clinic's limitations, patients respond best when HCPs are seen to be caring, supportive, hopeful, empathetic, and genuine in their encounters [ 27 ]. Caring HCPs can facilitate trusting relationships, empower patients, and ensure optimal patient care is provided [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…Fragmented health services, lack of collaboration between the community health center and the methadone treatment, and a biomedical approach to treatment are significant impediments to PCC being fully operationalized [ 27 ]. Nevertheless, although the provincial jurisdiction provides the biomedical framework of methadone treatment, possibilities of enhancing PCC can be imagined by reorienting the focus of methadone treatment to patient-centred and recovery-oriented care [ 27 ]. Such an approach would privilege patient engagement with care and recovery instead of seeking absolute abstinence from substances while on treatment [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, although the provincial jurisdiction provides the biomedical framework of methadone treatment, possibilities of enhancing PCC can be imagined by reorienting the focus of methadone treatment to patient-centred and recovery-oriented care [ 27 ]. Such an approach would privilege patient engagement with care and recovery instead of seeking absolute abstinence from substances while on treatment [ 27 ]. Recovery-oriented care emphasizes equitable distribution of services, patient-oriented goals and interventions to increase recovery capital [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recovery-oriented care, therefore, focuses on providing support and management at each stage of the recovery process, before initiating treatment, during treatment, and post-treatment [ 45 ]. Building recovery capital can include utilizing peer supports, focusing on reducing harm, educating HCPs to understand social justice principles for equitable distribution of resources, understanding historical trauma and the impact of racism on health, and working towards a treatment program rooted in PCC [ 27 , 33 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

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Plausibility of patient-centred care in high-intensity methadone treatment: reflections of providers and patients

Marshall

Maina

Sherstobitoff

2021

Addict Sci Clin Pract

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Background Patients with opioid use disorder (OUD) often have complex health care needs. Methadone is one of the medications for opioid use disorder (MOUD) used in the management of OUDs. Highly restrictive methadone treatment—which requires patient compliance with many rules of care—often results in low retention, especially if there is inadequate support from healthcare providers (HCPs). Nevertheless, HCPs should strive to offer patient-centred care (PCC) as it is deemed the gold standard to care. Such an approach can encourage patients to be actively involved in their care, ultimately increasing retention and yielding positive treatment outcomes. Methods In this secondary analysis, we aimed to explore how HCPs were applying the principles of PCC when caring for patients with OUD in a highly restrictive, biomedical and paternalistic setting. We applied Mead and Bower’s PCC framework in the secondary analysis of 40 in-depth, semi-structured interviews with both HCPs and patients. Results We present how PCC's concepts of; (a) biopsychosocial perspective; (b) patient as a person; (c) sharing power and responsibility; (d) therapeutic alliance and (e) doctor as a person—are applied in a methadone treatment program. We identified both opportunities and barriers to providing PCC in these settings. Conclusion In a highly restrictive methadone treatment program, full implementation of PCC is not possible. However, implementation of some aspects of PCC are possible to improve patient empowerment and engagement with care, possibly leading to increase in retention and better treatment outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Plausibility of patient-centred care in high-intensity methadone treatment: reflections of providers and patients

Marshall

Maina

Sherstobitoff

2021

Addict Sci Clin Pract

View full text Add to dashboard Cite

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Barriers and facilitators to opioid agonist treatment (OAT) engagement among individuals released from federal incarceration into the community in Ontario, Canada

Russell

Pang

Nafeh

et al. 2022

International Journal of Qualitative Studies on Health and Well

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Introduction Correctional populations with opioid use disorder experience increased health risks during community transition periods. Opioid Agonist Treatment (OAT) can reduce these risks, but retention is a key challenge. This study addresses a knowledge gap by describing facilitators and barriers to OAT engagement among federal correctional populations released into the community in Ontario, Canada. Methods This article describes results from a longitudinal mixed-methods study examining OAT transition experiences among thirty-five individuals released from federal incarceration in Ontario, Canada. Assessments were completed within one year of participants’ release. Data were thematically analyzed. Results The majority (77%) of participants remained engaged in OAT, however, 69% had their release suspended and 49% returned to custody. Key facilitators for OAT engagement included flexibility, positive staff rapport, and structure. Fragmented OAT transitions, financial OAT coverage, balancing reintegration requirements, logistical challenges, and inaccessibility of ‘take-home’ OAT medications were common barriers. Conclusions Post-incarceration transition periods are critical for OAT retention, yet individuals in Ontario experience barriers to OAT engagement that contribute to treatment disruptions and related risks such as relapse and/or re-incarceration. Additional measures to support community OAT transitions are required, including improved discharge planning, amendments to OAT and financial coverage policies, and an expansion of OAT options.

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Enhancing Treatment Access and Effectiveness: Toward Patient-Centered Models of Care

Cited by 2 publications

References 107 publications

Plausibility of patient-centred care in high-intensity methadone treatment: reflections of providers and patients

Plausibility of patient-centred care in high-intensity methadone treatment: reflections of providers and patients

Barriers and facilitators to opioid agonist treatment (OAT) engagement among individuals released from federal incarceration into the community in Ontario, Canada

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