Article type
Year
Abstract
Background: In Norway, Opioid Maintenance Treatment (OMT) is provided to people with opioid dependence. Understanding the experiences of patients and healthcare providers dealing with OMT can provide valuable information to improve quality of OMT services as well as to increase acceptability and accessibility to use OMT services.
Objectives: To study patients and healthcare providers experiences with OMT
Methods: We identified a rapid review from CADTH in a scoping stage of this work and decided to use this studies and a up-dating search. We conducted a systematic literature search in electronic databases in September 2019 and updated search for Norwegian studies in October 2019. Two employees independently screened through all titles and summaries and then through full text, to assess their relevance to the inclusion criteria. Three employees extracted the following data from the studies that met the inclusion criteria: Aim/research question, participants, context, methods, main results, and "data richness scale". Based on this information, three employees conducted a purposive sampling independently and came to a consensus for the final studies to include. We assessed the methodological quality of the included studies using the CASP Checklist. We used NVivo software for coding, and for the analysis, we used Andersen's model as a framework for understanding and describing contextual and individual factors, health behaviors and outcomes. We then, assessed confidence in the results with Grade CERQual.
Results: Based on the GRADE-CERQual assessment, we had high confidence in three of the findings. Stigma from people outside was a barrier to seeking out and remaining in treatment. OMT services itself was a source of stigma and communication and staff-patient relations were either facilitators or barriers to treatment compliance and outcomes. We had moderate confidence in two of the findings: Inadequate knowledge and competence among healthcare providers was a barrier as reported by both patients and healthcare providers, which affected the availability and quality of OMT. Patients had expectations of many non-health related individual outcomes of OMT. Our high confidence in these findings suggests that they are good representations of how participants experienced OMT.
Conclusions: Treatment-seeking behaviour, treatment compliance and outcomes of OMT are affected by stigma in society and within OMT, treatment processes such as communication and healthcare providers competence and patients' own expectations and attitudes towards OMT. Stigma is continuously weighed alongside expectations and needs as patients decide to seek OMT or to remain in OMT. These results show the need for increased competence, including competence in relational work, among OMT healthcare providers, to improve the quality of OMT and to avoid stigma and negative attitudes among the healthcare providers. OMT should also have a holistic approach to meet patients' non-health-related needs, as these seem to be crucial for treatment compliance and outcomes.
Objectives: To study patients and healthcare providers experiences with OMT
Methods: We identified a rapid review from CADTH in a scoping stage of this work and decided to use this studies and a up-dating search. We conducted a systematic literature search in electronic databases in September 2019 and updated search for Norwegian studies in October 2019. Two employees independently screened through all titles and summaries and then through full text, to assess their relevance to the inclusion criteria. Three employees extracted the following data from the studies that met the inclusion criteria: Aim/research question, participants, context, methods, main results, and "data richness scale". Based on this information, three employees conducted a purposive sampling independently and came to a consensus for the final studies to include. We assessed the methodological quality of the included studies using the CASP Checklist. We used NVivo software for coding, and for the analysis, we used Andersen's model as a framework for understanding and describing contextual and individual factors, health behaviors and outcomes. We then, assessed confidence in the results with Grade CERQual.
Results: Based on the GRADE-CERQual assessment, we had high confidence in three of the findings. Stigma from people outside was a barrier to seeking out and remaining in treatment. OMT services itself was a source of stigma and communication and staff-patient relations were either facilitators or barriers to treatment compliance and outcomes. We had moderate confidence in two of the findings: Inadequate knowledge and competence among healthcare providers was a barrier as reported by both patients and healthcare providers, which affected the availability and quality of OMT. Patients had expectations of many non-health related individual outcomes of OMT. Our high confidence in these findings suggests that they are good representations of how participants experienced OMT.
Conclusions: Treatment-seeking behaviour, treatment compliance and outcomes of OMT are affected by stigma in society and within OMT, treatment processes such as communication and healthcare providers competence and patients' own expectations and attitudes towards OMT. Stigma is continuously weighed alongside expectations and needs as patients decide to seek OMT or to remain in OMT. These results show the need for increased competence, including competence in relational work, among OMT healthcare providers, to improve the quality of OMT and to avoid stigma and negative attitudes among the healthcare providers. OMT should also have a holistic approach to meet patients' non-health-related needs, as these seem to be crucial for treatment compliance and outcomes.