Treatment satisfaction and quality of support in outpatient substitution treatment: opiate users’ experiences and perspectives

Abstract

Aims: Patient-reported outcomes have become an important source of information to guide service provision. Although opiate substitution treatment (OST) is an evidence-based and widely available intervention for opiate dependent individuals, evaluation studies have primarily focused on objective outcome indicators rather than on clients' perspectives and personal experiences. This study aims to assess opiate users' satisfaction with various aspects of substitution treatment and their subjective experiences and expectations regarding the provision of psychosocial support. Methods: The study sample consisted of 77 opiatedependent individuals who had been involved in OST for at least three months in some cities in Belgium. Qualitative interviews were used to explore clients' subjective experiences, in addition to some quantitative measures. Findings: About half of the respondents recently received some form of psychosocial support and they were generally satisfied about these services. However, the number of persons who wanted psychosocial support clearly outnumbered those actually receiving these services. Respondents stressed the importance of building trusting relationships with OST staff. Also, the need for more flexible and individualised support was emphasised. Conclusions: Compared with other stakeholders' perspectives or traditional outcome indicators, service users' subjective experiences shed an alternative light on the impact of opiate dependence and OST on individuals' daily lives. This information should be incorporated in individual treatment planning and when designing and evaluating OST services.

Effectiveness, safety and feasibility of extended‐release naltrexone for opioid dependence: a 9‐month follow‐up to a 3‐month randomized trial

“…Despite the effectiveness of OMT and its availability in many countries, it is utilized only by half of people with opioid dependence in Europe . There are opioid‐dependent adults who prefer not to receive OMT with opioid agonist medications, and may consider opioid antagonist treatment an alternative .…”

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“…The idea of patient-centred care stems from a wider moral vision of health care, and should be defined by what it is, rather than by what it is not [2]. Importantly, beyond services, patient-centred health care means focusing upon the outcomes that are important to patients and engaging them actively in an ongoing dialogue about their goals for treatment [3], and this is also relevant to patients undergoing substitution treatment [4]. Patient-centred care is about engaging patients, not accommodating them.…”

“…However, such aims and parameters are not necessarily the only ones relevant, and may not represent the central concerns of clients. At times, the content of services may matter less to the patients than how the services are delivered-the attitudes of counsellors, the accessibility of counselling on an as-needed basis and non-stigmatizing social encounters can be considered to be highly valuable [4,13]. Drug and alcohol research ought to also focus upon such subjective issues that are of utmost importance to the patients.…”

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