Client preferences for the design and delivery of injectable opioid agonist treatment services: Results from a best-worst scaling task.

IF 5.2 1区 医学 Q1 PSYCHIATRY Addiction Pub Date : 2024-12-01 Epub Date: 2024-07-25 DOI:10.1111/add.16620
Rebecca Kathleen Metcalfe, Sophia Dobischok, Nick Bansback, Scott MacDonald, David Byres, Julie Lajeunesse, Scott Harrison, Bryce Koch, Blue Topping, Terry Brock, Julie Foreman, Martin Schechter, Eugenia Oviedo-Joekes
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Abstract

Background and aims: Clinical trials support injectable opioid agonist treatment (iOAT) for individuals with opioid use disorder (OUD) for whom other pharmacological management approaches are not well-suited. However, despite substantial research indicating that person-centered care improves engagement, retention and health outcomes for individuals with OUD, structural requirements (e.g. drug policies) often dictate how iOAT must be delivered, regardless of client preferences. This study aimed to quantify clients' iOAT delivery preferences to improve client engagement and retention.

Design: Cross-sectional preference elicitation survey.

Setting: Metro Vancouver, British Columbia, Canada.

Participants: 124 current and former iOAT clients.

Measurements: Participants completed a demographic questionnaire package and an interviewer-led preference elicitation survey (case 2 best-worst scaling task). Latent class analysis was used to identify distinct preference groups and explore demographic differences between preference groups.

Findings: Most participants (n = 100; 81%) were current iOAT clients. Latent class analysis identified two distinct groups of client preferences: (1) autonomous decision-makers (n = 73; 59%) and (2) shared decision-makers (n = 51; 41%). These groups had different preferences for how medication type and dosage were selected. Both groups prioritized access to take-home medication (i.e. carries), the ability to set their own schedule, receiving iOAT in a space they like and having other services available at iOAT clinics. Compared with shared decision-makers, fewer autonomous decision-makers identified as a cis-male/man and reported flexible preferences.

Conclusions: Injectable opioid agonist treatment (iOAT) clients surveyed in Vancouver, Canada, appear to prefer greater autonomy than they currently have in choosing OAT medication type, dosage and treatment schedule.

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客户对设计和提供注射类阿片激动剂治疗服务的偏好:最佳-最差缩放任务的结果。
背景和目的:临床试验支持对阿片类药物使用障碍(OUD)患者进行注射阿片类激动剂治疗(iOAT),因为其他药物治疗方法并不适合这些患者。然而,尽管大量研究表明,以人为本的护理可提高阿片类药物滥用障碍患者的参与度、保留率和健康状况,但结构性要求(如药物政策)往往决定了必须如何提供 iOAT,而不考虑客户的偏好。本研究旨在量化客户对 iOAT 治疗方式的偏好,以提高客户的参与度和保留率:设计:横断面偏好诱导调查:地点:加拿大不列颠哥伦比亚省大温哥华地区:124名iOAT现任和前任客户:参与者填写了一份人口统计学问卷包和一份由访谈者主导的偏好激发调查(案例 2 最佳-最差缩放任务)。采用潜类分析法确定不同的偏好群体,并探讨不同偏好群体之间的人口统计学差异:大多数参与者(n = 100;81%)是目前的 iOAT 客户。潜类分析确定了两类不同的客户偏好:(1) 自主决策者(人数 = 73;59%)和 (2) 共同决策者(人数 = 51;41%)。这些群体对如何选择药物类型和剂量有着不同的偏好。这两组人都优先考虑可带回家服用的药物(即随身携带的药物)、能够自行设定时间表、在自己喜欢的场所接受 iOAT 治疗以及 iOAT 诊所提供的其他服务。与共同决策者相比,较少自主决策者认为自己是顺式男性/男性,并报告了灵活的偏好:结论:在加拿大温哥华接受调查的注射阿片类激动剂治疗(iOAT)患者似乎希望在选择 OAT 药物类型、剂量和治疗时间表方面拥有比目前更大的自主权。
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来源期刊
Addiction
Addiction 医学-精神病学
CiteScore
10.80
自引率
6.70%
发文量
319
审稿时长
3 months
期刊介绍: Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.
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