Using nominal group technique to identify barriers, facilitators, and preferences among patients seeking treatment for opioid use disorder: A needs assessment for decision making support

Muthulingam, Dharushana; Bia, Joshua; Madden, Lynn M.; Farnum, Scott O.; Barry, Declan T.; Altice, Frederick L.

doi:10.1016/j.jsat.2019.01.019

Cited by 49 publications

(42 citation statements)

References 73 publications

(76 reference statements)

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“…Our conceptualization of potential spatial accessibility considers the time travelled to a treatment provider by anyone who suffers an opioid overdose event and may need access to OUD treatment regardless of their grouping by social, economic, demographic or clinical factors [ 15 ]. Previous studies have identified several barriers to accessing OUD treatment, such as convenience of travel time [ 16 ], availability and capacity of treatment providers [ 17 , 18 ] and mode of transportation [ 19 ]. Building on these previous findings and leveraging the spatial turn in health research [ 20 ], we present a method for reconsidering the barriers that exist and addressing them through geographic considerations.…”

Section: Introductionmentioning

confidence: 99%

Opioid Treatment Deserts: Concept development and application in a US Midwestern urban county

et al. 2021

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Objectives An Opioid Treatment Desert is an area with limited accessibility to medication-assisted treatment and recovery facilities for Opioid Use Disorder. We explored the concept of Opioid Treatment Deserts including racial differences in potential spatial accessibility and applied it to one Midwestern urban county using high resolution spatiotemporal data. Methods We obtained individual-level data from one Emergency Medical Services (EMS) agency (Columbus Fire Department) in Franklin County, Ohio. Opioid overdose events were based on EMS runs where naloxone was administered from 1/1/2013 to 12/31/2017. Potential spatial accessibility was measured as the time (in minutes) it would take an individual, who may decide to seek treatment after an opioid overdose, to travel from where they had the overdose event, which was a proxy measure of their residential location, to the nearest opioid use disorder (OUD) treatment provider that provided medically-assisted treatment (MAT). We estimated accessibility measures overall, by race and by four types of treatment providers (any type of MAT for OUD, Buprenorphine, Methadone, or Naltrexone). Areas were classified as an Opioid Treatment Desert if the estimate travel time to treatment provider (any type of MAT for OUD) was greater than a given threshold. We performed sensitivity analysis using a range of threshold values based on multiple modes of transportation (car and public transit) and using only EMS runs to home/residential location types. Results A total of 6,929 geocoded opioid overdose events based on data from EMS agencies were used in the final analysis. Most events occurred among 26–35 years old (34%), identified as White adults (56%) and male (62%). Median travel times and interquartile range (IQR) to closest treatment provider by car and public transit was 2 minutes (IQR: 3 minutes) and 17 minutes (IQR: 17 minutes), respectively. Several neighborhoods in the study area had limited accessibility to OUD treatment facilities and were classified as Opioid Treatment Deserts. Travel time by public transit for most treatment provider types and by car for Methadone-based treatment was significantly different between individuals who were identified as Black adults and White adults based on their race. Conclusions Disparities in access to opioid treatment exist at the sub-county level in specific neighborhoods and across racial groups in Columbus, Ohio and can be quantified and visualized using local public safety data (e.g., EMS runs). Identification of Opioid Treatment Deserts can aid multiple stakeholders better plan and allocate resources for more equitable access to MAT for OUD and, therefore, reduce the burden of the opioid epidemic while making better use of real-time public safety data to address a public health epidemic that has turned into a public safety crisis.

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Section: Introductionmentioning

confidence: 99%

Opioid Treatment Deserts: Concept development and application in a US Midwestern urban county

et al. 2021

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“…Select recent evidence from across populations and settings reveals similarities in peoples’ experiences. For example, structural barriers include the costs and convenience of treatment [11, 12], societal stigma [11–13] and the attitudes and behaviours of health care providers [12, 14]. Research has also shown that people’s preferred treatment goals and outcomes are often incongruent with those of the health care system [15–17].…”

Section: Introductionmentioning

confidence: 99%

Conceptualizing patient-centered care for substance use disorder treatment: findings from a systematic scoping review

Marchand

Beaumont

Westfall³

et al. 2019

Subst Abuse Treat Prev Policy

142

110

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Background Despite ongoing efforts aimed to improve treatment engagement for people with substance-related disorders, evidence shows modest rates of utilization as well as client-perceived barriers to care. Patient-centered care (PCC) is one widely recognized approach that has been recommended as an evidence-based practice to improve the quality of substance use disorder treatment. PCC includes four core principles: a holistic and individualized focus to care, shared decision-making and enhanced therapeutic alliance. Aims This scoping review aimed to explore which PCC principles have been described and how they have defined and measured among people with substance-related disorders. Methods Following the iterative stages of the Arksey and O’Malley scoping review methodology, empirical (from Medline, Embase, PsycINFO, CINAHL and ISI Web of Science) and grey literature references were eligible if they focused on people accessing treatment for substance-related disorders and described PCC. Two reviewers independently screened the title/abstract and full-texts of references. Descriptive analyses and a directed content analysis were performed on extracted data. Findings One-hundred and forty-nine references met inclusion from the 2951 de-duplicated references screened. Therapeutic alliance was the most frequent principle of PCC described by references (72%); this was consistently defined by characteristics of empathy and non-judgment. Shared decision-making was identified in 36% of references and was primarily defined by client and provider strategies of negotiation in the treatment planning process. Individualized care was described by 30% of references and included individualized assessment and treatment delivery efforts. Holistic care was identified in 23% of references; it included an integrated delivery of substance use, health and psychosocial services via comprehensive care settings or coordination. Substance use and treatment engagement outcomes were most frequently described, regardless of PCC principle. Conclusions This review represents a necessary first step to explore how PCC has been defined and measured for people accessing substance use disorder treatment. The directed content analysis revealed population and context-specific evidence regarding the defining characteristics of PCC-principles that can be used to further support the implementation of PCC.

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“…There have been several studies so far to reveal the reasons behind the engagement of OUDs patients in treatment programs. To the best of our knowledge, while some of these studies focused on features of treatment programs as motives for treatment commencement [ 24 , 29 , 35 – 39 ], few investigated the OUDs associated problems as motives for treatment-seeking [ 5 , 17 , 40 ]. The present study is among the few studies to explore reasons different from treatment programs’ features as motives for treatment-seeking among OUD patients in Iran.…”

Section: Introductionmentioning

confidence: 99%

Redemption from plight: a qualitative study on reasons behind treatment decisions among Iranian male opioid users

Rarani

Morasae

Pashaei

et al. 2020

Subst Abuse Treat Prev Policy

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Background: Opioid use remains a significant cause of harm to individual health. Perceived motives are of the main factors that help lead a patient into seeking treatment voluntarily to obviate that harm. The current study expands on the literature by exploring when and how male users of opioids become motivated to voluntarily seek treatment services. Methods: In a qualitative study in Isfahan city from January 2018 to March 2019, 55 male participants who had already started a variety of treatment services to withdraw their dependence on opioids were recruited. Selection of participants was based on a maximum variation purposive sampling strategy. Each participant took part in a unstructured interview to identify his motives for seeking opioid use treatment. Interviews were undertaken in eight different treatment centers. An inductive thematic analysis method was used to analyze the interviews. Results: The findings highlight that Iranian male opioid users have different motivations to seek treatment. To be precise, the findings illuminate three global themes and six themes as treatment-seeking motives among the participants including; motives related to family (reason for family and reason of family), quality of life (adverse effects on personal lifestyle and health) and economic motives (financial failure and job failure). Conclusions: The findings can improve our understanding of the motives for seeking treatment from the perspective of opioid patients who entered themselves into treatment. Particularly, these findings could help policymakers and treatment providers to better understand opioid-use patient's perceived concerns and fears as motives for treatment-seeking.

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Using nominal group technique to identify barriers, facilitators, and preferences among patients seeking treatment for opioid use disorder: A needs assessment for decision making support

Cited by 49 publications

References 73 publications

Opioid Treatment Deserts: Concept development and application in a US Midwestern urban county

Opioid Treatment Deserts: Concept development and application in a US Midwestern urban county

Conceptualizing patient-centered care for substance use disorder treatment: findings from a systematic scoping review

Redemption from plight: a qualitative study on reasons behind treatment decisions among Iranian male opioid users

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