Building healthcare provider relationships for patient-centered care: A qualitative study of the experiences of people receiving injectable opioid agonist treatment
Abstract Background Injectable opioid agonist treatment (iOAT) was designed as a pragmatic and compassionate approach for people who have not benefitted from medication assisted treatment with oral opioids (e.g., methadone). While, a substantial body of clinical trial evidence has demonstrated the s...
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| Format: | Article |
| Language: | English |
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BMC
2020-01-01
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| Series: | Substance Abuse Treatment, Prevention, and Policy |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13011-020-0253-y |
| _version_ | 1831693467713011712 |
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| author | Kirsten Marchand Julie Foreman Scott MacDonald Scott Harrison Martin T. Schechter Eugenia Oviedo-Joekes |
| author_facet | Kirsten Marchand Julie Foreman Scott MacDonald Scott Harrison Martin T. Schechter Eugenia Oviedo-Joekes |
| author_sort | Kirsten Marchand |
| collection | DOAJ |
| description | Abstract Background Injectable opioid agonist treatment (iOAT) was designed as a pragmatic and compassionate approach for people who have not benefitted from medication assisted treatment with oral opioids (e.g., methadone). While, a substantial body of clinical trial evidence has demonstrated the safety and effectiveness of iOAT, considerably less is known about the patient-centered aspects of this treatment and their role in self-reported treatment goals and outcomes. The aim of this study was to explore participants’ experiences in iOAT as they broadly relate to the domains of patient-centered care. A secondary goal was to explore how these experiences affected participants’ self-reported treatment outcomes. Methods A qualitative methodology, and constructivist grounded theory approach, was used to guide sampling, data collection and analysis. A total of 30 in-depth interviews were conducted with people receiving iOAT in North America’s first clinic. Audio-recordings for each semi-structured interview were transcribed and read repeatedly. The strategy of constant comparison was used through iterative stages of line-by-line, focused and theoretical coding until theoretical saturation was achieved. Results “Building healthcare provider relationships for patient-centered care in iOAT” was the emergent core concept. Healthcare provider relationships were established through two interrelated processes: ‘Opening up’ was attributed to the positive environment, and to feeling understood and supported by healthcare providers. ‘Being a part of care’ emerged as participants felt safe to ask for what was needed and had opportunities to collaborate in treatment decisions. These processes established a foundation in which participants experienced care that was responsive to their individual dose, health and psychosocial needs. Conclusions The core concept suggested that therapeutic relationships were fundamental to experiences of patient-centered care in iOAT. When relationships were respectful and understanding, participants received individualized and holistic care in iOAT. These findings offer a valuable example of how therapeutic relationships can be strengthened in other substance use treatment settings, particularly when responding to the diverse treatment needs of clients. |
| first_indexed | 2024-12-20T12:15:12Z |
| format | Article |
| id | doaj.art-b1721e4d55704ae7b0b54f63b6aed189 |
| institution | Directory Open Access Journal |
| issn | 1747-597X |
| language | English |
| last_indexed | 2024-12-20T12:15:12Z |
| publishDate | 2020-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Substance Abuse Treatment, Prevention, and Policy |
| spelling | doaj.art-b1721e4d55704ae7b0b54f63b6aed1892022-12-21T19:41:10ZengBMCSubstance Abuse Treatment, Prevention, and Policy1747-597X2020-01-011511910.1186/s13011-020-0253-yBuilding healthcare provider relationships for patient-centered care: A qualitative study of the experiences of people receiving injectable opioid agonist treatmentKirsten Marchand0Julie Foreman1Scott MacDonald2Scott Harrison3Martin T. Schechter4Eugenia Oviedo-Joekes5School of Population and Public Health, University of British ColumbiaProvidence Health Care, Providence Crosstown ClinicProvidence Health Care, Providence Crosstown ClinicProvidence Health Care, Providence Crosstown ClinicSchool of Population and Public Health, University of British ColumbiaSchool of Population and Public Health, University of British ColumbiaAbstract Background Injectable opioid agonist treatment (iOAT) was designed as a pragmatic and compassionate approach for people who have not benefitted from medication assisted treatment with oral opioids (e.g., methadone). While, a substantial body of clinical trial evidence has demonstrated the safety and effectiveness of iOAT, considerably less is known about the patient-centered aspects of this treatment and their role in self-reported treatment goals and outcomes. The aim of this study was to explore participants’ experiences in iOAT as they broadly relate to the domains of patient-centered care. A secondary goal was to explore how these experiences affected participants’ self-reported treatment outcomes. Methods A qualitative methodology, and constructivist grounded theory approach, was used to guide sampling, data collection and analysis. A total of 30 in-depth interviews were conducted with people receiving iOAT in North America’s first clinic. Audio-recordings for each semi-structured interview were transcribed and read repeatedly. The strategy of constant comparison was used through iterative stages of line-by-line, focused and theoretical coding until theoretical saturation was achieved. Results “Building healthcare provider relationships for patient-centered care in iOAT” was the emergent core concept. Healthcare provider relationships were established through two interrelated processes: ‘Opening up’ was attributed to the positive environment, and to feeling understood and supported by healthcare providers. ‘Being a part of care’ emerged as participants felt safe to ask for what was needed and had opportunities to collaborate in treatment decisions. These processes established a foundation in which participants experienced care that was responsive to their individual dose, health and psychosocial needs. Conclusions The core concept suggested that therapeutic relationships were fundamental to experiences of patient-centered care in iOAT. When relationships were respectful and understanding, participants received individualized and holistic care in iOAT. These findings offer a valuable example of how therapeutic relationships can be strengthened in other substance use treatment settings, particularly when responding to the diverse treatment needs of clients.https://doi.org/10.1186/s13011-020-0253-yPatient-centered careInjectable opioid agonist treatmentOpioid use disorderPatient-reported outcomesGrounded theory |
| spellingShingle | Kirsten Marchand Julie Foreman Scott MacDonald Scott Harrison Martin T. Schechter Eugenia Oviedo-Joekes Building healthcare provider relationships for patient-centered care: A qualitative study of the experiences of people receiving injectable opioid agonist treatment Substance Abuse Treatment, Prevention, and Policy Patient-centered care Injectable opioid agonist treatment Opioid use disorder Patient-reported outcomes Grounded theory |
| title | Building healthcare provider relationships for patient-centered care: A qualitative study of the experiences of people receiving injectable opioid agonist treatment |
| title_full | Building healthcare provider relationships for patient-centered care: A qualitative study of the experiences of people receiving injectable opioid agonist treatment |
| title_fullStr | Building healthcare provider relationships for patient-centered care: A qualitative study of the experiences of people receiving injectable opioid agonist treatment |
| title_full_unstemmed | Building healthcare provider relationships for patient-centered care: A qualitative study of the experiences of people receiving injectable opioid agonist treatment |
| title_short | Building healthcare provider relationships for patient-centered care: A qualitative study of the experiences of people receiving injectable opioid agonist treatment |
| title_sort | building healthcare provider relationships for patient centered care a qualitative study of the experiences of people receiving injectable opioid agonist treatment |
| topic | Patient-centered care Injectable opioid agonist treatment Opioid use disorder Patient-reported outcomes Grounded theory |
| url | https://doi.org/10.1186/s13011-020-0253-y |
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