Patients' knowledge about treatment for opiate dependence

Alves, Paula; Winstock, Adam

doi:10.1192/pb.bp.111.034546

Cited by 4 publications

(3 citation statements)

References 30 publications

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“…Improving patients’ knowledge and understanding about OST through targeted education was suggested for both PWIDs and treatment providers in China (Liu et al, 2013) and the United Kingdom (Alves & Winstock, 2011). Countering the myths and misinformation about OST and methadone uncovered in the focus group discussions is an important first step to expanding OST and other medication-assisted therapies in Ukraine.…”

Section: Discussionmentioning

confidence: 99%

“Bureaucracy & Beliefs”: Assessing the barriers to accessing opioid substitution therapy by people who inject drugs in Ukraine

Bojko

Mazhnaya

Makarenko

et al. 2015

Drugs: Education, Prevention and Policy

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Aims Opioid substitution therapy (OST) is an evidence-based HIV prevention strategy for people who inject drugs (PWIDs). Yet, only 2.7% of Ukraine’s estimated 310,000 PWIDs receive it despite free treatment since 2004. The multi-level barriers to entering OST among opioid dependent PWIDs have not been examined in Ukraine. Methods A multi-year mixed methods implementation science project included focus group discussions with 199 PWIDs in 5 major Ukrainian cities in 2013 covering drug treatment attitudes and beliefs and knowledge of and experiences with OST. Data were transcribed, translated into English and coded. Coded segments related to OST access, entry, knowledge, beliefs and attitudes were analyzed among 41 PWIDs who were eligible for but had never received OST. Findings A number of programmatic and structural barriers were mentioned by participants as barriers to entry to OST, including compulsory drug user registration, waiting lists, and limited number of treatment slots. Participants also voiced strong negative attitudes and beliefs about OST, especially methadone. Their perceptions about methadone’s side effects as well as the stigma of being a methadone client were expressed as obstacles to treatment. Conclusions Despite expressed interest in treatment, Ukrainian OST-naïve PWIDs evade OST for reasons that can be addressed through changes in program-level and governmental policies and social-marketing campaigns. Voiced OST barriers can effectively inform public health and policy directives related to HIV prevention and treatment in Ukraine to improve evidence-based treatment access and availability.

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Section: Discussionmentioning

confidence: 99%

“Bureaucracy & Beliefs”: Assessing the barriers to accessing opioid substitution therapy by people who inject drugs in Ukraine

Bojko

Mazhnaya

Makarenko

et al. 2015

Drugs: Education, Prevention and Policy

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“…Despite this overall interest in patient involvement, the patient perspective in substance misuse treatment settings remains relatively unexplored and unheard (Orford, [ 5 ]). According to Orford [ 1 ], this is one of the ten aspects needing an urgent shift in the provision of substance treatment, where patients tend to be misinformed about the rationale behind their treatment plans [ 10 ]. Hence, listening to patients is a powerful strategy to explore what patients specifically need from treatment services, potentially avoiding outcomes or early treatment drop-out.…”

Section: Introductionmentioning

confidence: 99%

Enhancing the patient involvement in outcomes: a study protocol of personalised outcome measurement in the treatment of substance misuse

2013

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BackgroundInvolving patients in treatment is becoming increasingly popular in mental health [Sales & Alves: Personalized evaluation of psychological treatments: A review of tools and research designs, submitted]. However, in substance misuse treatment settings, the patient perspective about treatment tends to be overlooked. This has been cited as a key priority by Orford et al. [Addiction, 103: 875-885, 2008] who included patient feedback about treatment as one of ten areas requiring an urgent paradigm shift in addiction research and practice.This project will apply an innovative method to involve substance misuse patients in psychological therapies, by asking them to suggest topics to evaluate their treatment. These topics suggested by patients can be written as a list of personalised items, so-called as patient-generated outcome measures (PGOM). Despite its patient-friendly features, PGOM’s have never been used in this population, which is what this project aims to overcome.Methods/designThis project is part of an International Exchange Platform on Personalising Addiction Treatment. Data will be collected in two phases (pre-post study and focus groups with patients) to explore the following:1). How reliable and sensitive to change are PGOM’s and standardised measures in substance misuse treatment?2). Do PGOM’s add relevant information to standardised measures?3). What are the views of substance misuse patients about personalised outcome assessment?4). Development of guidelines on using PGOM’s in this populationDiscussionThis research will potentially demonstrate the diversity of personal problems among patients seeking substance misuse treatment, suggesting the relevance of PGOM as a method to personalise outcome measurement and, ultimately, guiding treatment provision. It is expected that, as in previous studies, PGOM’s will be perceived as helpful and patient-friendly tools, where patients may express their own concerns in a semi-structured setting. Similarly to other populations, we also expect PGOM’s to be reliable, valid and sensitive to clinical changes in substance misuse treatment, as well as more content informative than their standardised counterparts. If these results are achieved, we might hypothesize that PGOM’s are a potentially valid supplement to traditional standardised scales, by providing a closer insight to what motivates patients to participate in substance misuse treatment programmes.

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“…According to participants in our focus groups, OST clinics neither provide patients with educational information on the type of side effects MMT may cause, nor on effective and healthy ways to cope with these side effects. Improving patients' knowledge and understanding of MMT may increase treatment adherence, provide an alternative to methamphetamine use, and improve health outcomes (35).…”

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confidence: 99%

Methamphetamine Use Among Patients Undergoing Methadone Maintenance Treatment in Iran; a Threat for Harm Reduction and Treatment Strategies: A Qualitative Study

Radfar

Cousins

Shariatirad

et al. 2016

Int J High Risk Behav Addict

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Background: Opiates are the most commonly reported substances of abuse in Iran. Over two thirds (68%) of all newly identified HIV cases in Iran are among people who inject drugs. On the heels of the HIV epidemic, methamphetamine use has grown. Public health officials are concerned that methamphetamine use has gained popularity among individuals who use opioid substitution therapy, such as methadone maintenance therapy. Objectives: The purpose of this qualitative study is to inform stakeholders of the motivations and experiences of MMT patients who use methamphetamine. Patients and Methods: To gain a better understanding of patients' motivations and experiences with MMT and methamphetamine, the authors conducted 7 focus groups with 45 participants in drop-in centers, public outpatient clinics, and a private outpatient clinic in Isfahan, Iran. Results: Patients reported that their use of methamphetamine was motivated by methadone's side effects and encouraged by family and friends who promoted methamphetamine use to assuage the side effects of methadone in the early stages of treatment before the appearance of methadone maintenance therapy's effects on their life. Conclusions: Findings suggest that there is a need for evidence-based practices in methadone maintenance therapy programs in Iran to reduce methamphetamine use among methadone maintenance therapy patients. Methamphetamine use among methadone maintenance therapy patients in Iran can reduce the efficacy of these services in reducing risky behaviors as well as other desired outcomes of methadone maintenance therapy. Our findings suggest two strategies that may be of use (or our findings suggest that two strategies that may be of use are: 1) educate patients and their families about methadone's side effects and the contraindications of methamphetamine use by treatment team and/or peer groups' educators; 2) integrate routine amphetamine testing into methadone treatment. These findings may be useful to those designing and implementing strategies for reducing methamphetamine use in methadone maintenance therapy programs in Iran.

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Patients' knowledge about treatment for opiate dependence

Cited by 4 publications

References 30 publications

“Bureaucracy & Beliefs”: Assessing the barriers to accessing opioid substitution therapy by people who inject drugs in Ukraine

“Bureaucracy & Beliefs”: Assessing the barriers to accessing opioid substitution therapy by people who inject drugs in Ukraine

Enhancing the patient involvement in outcomes: a study protocol of personalised outcome measurement in the treatment of substance misuse

Methamphetamine Use Among Patients Undergoing Methadone Maintenance Treatment in Iran; a Threat for Harm Reduction and Treatment Strategies: A Qualitative Study

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