Examining the Primary Care Experience of Patients With Opioid Use Disorder: A Qualitative Study

Abstract

Objectives: Despite substantial investment in expanding access to treatment for opioid use disorder (OUD), overdose deaths continue to increase. Primary care holds enormous potential to expand access to OUD treatment, but few patients receive medications for OUD (MOUD) in primary care. Understanding both patient and clinician experiences is critical to expanding access to patient-centered MOUD care, yet relatively little research has examined patient perspectives on primary care-based MOUD. We sought to examine the care experiences of patients with OUD receiving medication-based treatment in a primary care setting. Methods: We conducted semistructured interviews with patients receiving MOUD at a single primary care site at the University of Utah. Interviews were performed and transcribed by qualitative researchers, who used rapid qualitative analysis using a grounded theory-based approach to identify key themes pertaining to patient experiences receiving medication-based OUD treatment in primary care.Results: Twenty-one patients were screened, and 14 completed the interview. In general, participants had numerous medical and psychiatric comorbidities. The following key themes pertaining to primary carebased OUD treatment were identified: (1) overall health improvement, (2) team-based care, (3) comparing primary care to specialty addiction treatment, (4) access to medications for OUD, and (5) discrimination and stigma. Conclusions: Patients reported many advantages to receiving primary care-based MOUD treatment. In particular, the flexibility and added support of team-based care along with the convenience of receiving addiction treatment alongside regular medical care were highly valued. These findings can be used to develop patient-centered initiatives aimed at expanding OUD treatment within primary care.

Virtual Primary Care for People with Opioid Use Disorder: A Scoping Review of Current Strategies, Benefits, and Challenges

“…Additionally, harm reduction services were provided (such as syringe exchange and naloxone distribution [67]), although to a lesser extent (n=3, 10.7%). Few studies (n=6, 21.4%) described other primary care needs (e.g., vaccinations [68], diabetes [69]), and lacked specific details on the care provided (e.g., was listed as ‘other health needs’ [65] or ‘other clinics’ [64]).…”

“…Few studies (n=6, 21.4%) described other primary care needs (e.g., vaccinations [68], diabetes [69]), and lacked specific details on the care provided (e.g., was listed as 'other health needs' [65] or 'other clinics' [64]).…”

“…Describe patient experiences of Ancillary Respectful, team-based care allowed flexibility for virtual appointments. Virtual [69] receiving OUD care in primary care.…”

Evaluation of a Primary Care-Based Multidisciplinary Transition Clinic for Patients Newly Initiated on Buprenorphine in the Emergency Department

“…With the elimination of the requirement that US clinicians obtain an X-waiver to prescribe buprenorphine in January 2023, the magnitude of primary care's potential impact in providing MOUD cannot be overstated. Yet despite evidence that primary care physicians provide high-quality OUD care, 10 and patients may prefer primary care-based MOUD, 11 the great majority of primary care physicians have been reluctant to prescribe buprenorphine. [12][13][14] Access to specialty expertise and extra support staff have been highlighted as important facilitators to increase primary care providers' (PCP) comfort prescribing buprenorphine for MOUD.…”