Practitioner perspectives on working with older patients in opioid agonist treatment (OAT) in Norway: opportunities and challenges.

IF 3.7 2区 医学 Q1 SUBSTANCE ABUSE Addiction Science & Clinical Practice Pub Date : 2024-05-23 DOI:10.1186/s13722-024-00473-7
John Todd-Kvam, Thomas Clausen
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Abstract

Background: Norway has a growing proportion of ageing opioid agonist treatment (OAT) patients, with 42% of the 8300 Norwegian OAT patients aged over 50 in 2022. This study aims to explore practitioners' views and experiences from treatment of ageing OAT patients.

Methods: Data were collected as a series of semi-structured interviews with treatment staff (roles interviewed: doctor, psychologist, social worker, nurse, and learning disability nurse). Participants were recruited from three OAT outpatient clinics, one with an urban catchment area and two with a mix of urban and rural. The interviews incorporated questions on patients' somatic and mental health, strengths and weaknesses of the service for this group, and patients' quality of life.

Results: Older patients were perceived to be more often stable in terms of substance use and housing situation, but also experiencing some key challenges in terms of cognitive impairment, loneliness and isolation, and comorbidities. Both the practitioner-patient relationship and healthcare interactions outside OAT had the potential to impact treatment quality positively or negatively depending on how they were managed.

Conclusions: Treating older patients in a way that respects and enhances their dignity is important. We argue that this requires better services for those whose functioning is impacted by cognitive impairment/dementia, an age-informed treatment model for this patient group, along with urgent work to improve municipal-level services given practitioners describe them as unacceptable in certain areas.

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挪威阿片类激动剂治疗(OAT)从业人员对老年患者工作的看法:机遇与挑战。
背景:挪威阿片类受体激动剂治疗(OAT)患者中老年人的比例越来越高,到2022年,8300名挪威OAT患者中有42%的年龄超过50岁。本研究旨在探讨从业人员对老年阿片类受体激动剂患者治疗的看法和经验:通过对治疗人员(受访者的角色:医生、心理学家、社会工作者、护士和学习障碍护士)进行一系列半结构化访谈来收集数据。访谈对象来自三家 OAT 门诊诊所,其中一家位于城市地区,另外两家位于城乡结合部。访谈内容包括患者的躯体和心理健康、为该群体提供服务的优缺点以及患者的生活质量等问题:结果:老年患者在药物使用和住房情况方面通常比较稳定,但在认知障碍、孤独寂寞和合并症方面也面临一些主要挑战。从业人员与患者之间的关系以及 OAT 之外的医疗互动都有可能对治疗质量产生积极或消极的影响,这取决于如何处理这些关系:以尊重和提高老年患者尊严的方式对待他们非常重要。我们认为,这就需要为那些功能受到认知障碍/痴呆影响的患者提供更好的服务,为这一患者群体提供以年龄为基础的治疗模式,同时,鉴于从业人员认为某些地区的市政服务无法接受,因此迫切需要改善市政服务。
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来源期刊
Addiction Science & Clinical Practice
Addiction Science & Clinical Practice Psychology-Clinical Psychology
CiteScore
3.90
自引率
10.80%
发文量
64
审稿时长
28 weeks
期刊介绍: Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings. Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use. Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations. Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.
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