Patients' help‐seeking behaviours for health problems associated with methadone and buprenorphine treatment

Winstock, Adam; Lea, Toby; Sheridan, Janie

doi:10.1080/09595230802093745

Cited by 15 publications

(5 citation statements)

References 24 publications

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“…A number of participants reported having to manage co‐morbidities, such as cardio‐vascular issues, respiratory illness or muscle wastage and weight loss. These findings are not dissimilar to other studies that have documented the link between psychiatric and physiological illness and ongoing interactions between a narcotic and other pharmaceuticals . However, what is interesting is at least three participants reported having challenges in getting access to specialist care and also to general practitioners who could assist with co‐morbidities.…”

Section: Discussionsupporting

confidence: 46%

The lived experience of Australian opioid replacement therapy recipients in a community‐based program in regional Victoria

Patil

Cash

Cant

et al. 2019

Drug and Alcohol Review

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Introduction and Aims Treatment of opioid dependence through opioid replacement therapy is widely recognised as effective. Nonetheless, while there has been a community‐based program in the state of Victoria for over two decades, consumer experiences have received little attention. This study aimed to describe the experiences of opioid replacement therapy consumers living in rural and regional areas of the state. Design and Methods A qualitative design employed an interpretative phenomenological approach. Sixteen consumers were interviewed. Thematic analysis was conducted by the researchers to examine the phenomena of consumers′ experiences and findings were verified by a stakeholder group. Results Findings centred on themes of consumers′ experience of becoming recipients; consumer perceptions of pharmacists and pharmacy settings and psychosocial impacts on consumers. A majority of participants believed opioid replacement therapy brought increased normality to their life, however systemic and psychosocial barriers impacted on well‐being. The pharmacy setting itself as a public dosing space commonly provoked feelings of stigma and discrimination among consumers. Other barriers prominently reported were restrictions on number of takeaways, cost of dispensing and lack of access to medical practitioners and allied supports. Discussion and Conclusions There were psychosocial impacts on opioid replacement therapy consumers relating to financial and social burdens, stigma and discrimination. Access to medical care and a choice of pharmacy appeared to be restricted in rural regions. The findings suggest a need to address, in particular, the financial and dispensing point burdens experienced by consumers to facilitate program retention.

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Section: Discussionsupporting

confidence: 46%

The lived experience of Australian opioid replacement therapy recipients in a community‐based program in regional Victoria

Patil

Cash

Cant

et al. 2019

Drug and Alcohol Review

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“…33 From a consumer perspective, one study identified "considerable unmet needs", seen to be within the ambit of primary healthcare providers such as pharmacists who provide OST services. 34 OST patients in the study expressed their need for more help with health issues such as dental problems, constipation, sweating and sexual enjoyment. Those on more than 100mg of methadone daily were also more likely to need help with excessive sedation.…”

Section: Provision Of Opioid Substitution Therapy Services In Australmentioning

confidence: 95%

“…The study concluded that treatment providers should consider improving detection and response to common health problems experienced by patients on OST. 34 In another study investigating consumer perspectives, researchers , observed that in general consumers expressed high levels of satisfaction with OST services in pharmacies in NSW, but that there was less satisfaction with the quality of privacy afforded them, and the fact that OST patients claimed to be made to wait longer than other patients or clients in the pharmacy, perceiving they were "treated differently". 35 Interestingly, 23% of the participants in this study were in debt to the pharmacy for their dispensing fees.…”

Section: Provision Of Opioid Substitution Therapy Services In Australmentioning

confidence: 99%

Provision of opioid substitution therapy services in Australian pharmacies

Chaar

Hanrahan²,

Day³

2011

AMJ

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Opioid dependence, despite being the subject of significant public funding, remains a costly burden to Australian society in human and economic terms. The most cost-effective public health strategy for managing opioid dependence is opioid substitution therapy (OST), primarily through the use of methadone or buprenorphine. Supervised dispensing of OST from specialist clinics and community pharmacies plays a crucial role in enhancing compliance, monitoring treatment and reducing diversion. Australia, compared with other countries in the world, ranks very high in illicit opioid use; hence there is a great demand for OST.The utilisation of community pharmacies for stable patients has many advantages. For public clinics, patient transfer to community pharmacies relieves workload and costs, and increases capacity for new OST patients. From a patient's perspective, dosing at a pharmacy is more flexible and generally more preferable. Pharmacists stand to gain clientele, profit and receive small incentives from state governments in Australia, for their services. Yet, many "unmet needs" exist and there is a high demand for more involvement in OST service provision in community pharmacy in Australia.In the UK there has been a steady increase in community pharmacy provision of OST, and pharmacists appear ready to provide further healthcare services to these patients.The role of pharmacy in some countries in Europe, such as Germany, is less prominent due to their approach to harm minimisation and the complex, variable nature of OST provision across the European Union (EU). The provision of OST by pharmacists in the USA on the other hand is of lesser frequency as the healthcare system in the USA encourages detoxification clinics to handle cases of illicit drug addiction.At a time when harm minimisation strategies constitute a topic of considerable political and public interest, it is important to understand the scope and variability of pharmacy involvement in drug policy in Australia. Hence, this review highlights the role of pharmacists in OST and explores the scope for expanding this role in the future.

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“…Long-term conditions might be normalized by the patients and not brought up spontaneously. On the other hand, patients in Australia in OST with methadone and buprenorphine reported that dental problems, constipation and headache were the most common reasons for healthcare seeking, while sweating (26%) and sexual dysfunction (24%) were reported as problems for which the participants would currently like help with [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to the findings indicating poor physical health and great healthcare needs among OST patients, a few previous studies have shown that patients in OST commonly have self-reported unmet healthcare needs and reluctance towards healthcare seeking [ 19 , 22 ]. A recent study from Malmö, Sweden, showed low rates of circulatory diagnoses among OST patients, which likely indicates underdiagnosing in this patient group [ 23 ].…”

Section: Introductionmentioning

confidence: 86%

Healthcare utilization for somatic conditions among Swedish patients in opioid substitution treatment, with and without on-site primary healthcare

Vikbladh

Troberg

Håkansson

et al. 2022

BMC Health Serv Res

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Background Opioid substitution treatment (OST) populations are aging and have increased mortality and somatic morbidity compared to general populations internationally. While OST patients have poor self-rated physical health and unmet healthcare needs, documented healthcare utilization has been sparsely investigated. The aim of this study was to assess registered healthcare utilization for somatic conditions in a sample of Swedish OST patients, and compare healthcare utilization among OST patients with and without use of on-site primary healthcare (PHC). Methods Patients in OST in Malmö, Sweden, were recruited for a survey study conducted in 2017–2018. Survey data were compared with comprehensive patient records from specialized and primary care during one year prior to study inclusion (total n = 190). All patient records were examined for healthcare utilization, source of healthcare (PHC, emergency care and secondary care), and documented diagnoses and symptoms. Factors associated with healthcare utilization were analyzed by using logistic regression analysis. Patients with and without on-site PHC were compared by using descriptive statistics and Chi-2 test. Results A total of 88% of the sample had been in direct or indirect contact with somatic healthcare during one year (PHC 66%; emergency care 28%; secondary care 67%). The most prevalent somatic diagnoses were infectious diseases (39%) and symptom diagnoses (37%). Respiratory, dermatological and musculoskeletal diagnoses, and trauma/intoxication were documented in 21–26% of the sample, respectively. PHC utilization was associated with older age and being born in Sweden. Among patients with on-site PHC (n = 25), the number utilizing secondary care was 84%, and certain diagnostic codes were more frequent in this group. Conclusion OST patients are seemingly underserved as regards their physical health. Since increased OST access decreases opioid overdose fatalities, the life expectancy among OST patients is likely to increase and thereby also increases the risk of age-related conditions. Thus, easily accessible physical healthcare is of great importance in this group. On-site PHC might be a way to establish healthcare contact with OST patients, especially for non-acute conditions, although further research is needed.

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Patients' help‐seeking behaviours for health problems associated with methadone and buprenorphine treatment

Abstract: The considerable unmet health care needs among participants in this study suggest that treatment providers should consider improving the detection and response to common health problems related to opioid substitution therapy.

Cited by 15 publications

References 24 publications

The lived experience of Australian opioid replacement therapy recipients in a community‐based program in regional Victoria

The lived experience of Australian opioid replacement therapy recipients in a community‐based program in regional Victoria

Provision of opioid substitution therapy services in Australian pharmacies

Healthcare utilization for somatic conditions among Swedish patients in opioid substitution treatment, with and without on-site primary healthcare

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