FULFILLING AN UNMET NEED: PATIENT PERSPECTIVES ON INTEGRATING FAMILY PLANNING SERVICES INTO OFFICE-BASED ADDICTION THERAPY

Abstract

Objectives

Our objective was to study patient perspectives on facilitators and barriers to incorporation of family planning services within office-based addiction therapy (OBAT). After previously exploring provider perspectives, we sought to understand the unique patient considerations on integration within the OBAT model with the goal to support design of a program tailored to meet the reproductive health needs of patients with substance use disorder (SUD).

Methods

Following IRB approval, we conducted 20 qualitative semi-structured interviews with Boston Medical Center OBAT patients. Interviews explored participants substance use and reproductive health, OBAT experiences and unique considerations when accessing reproductive healthcare within addiction care. Interview transcripts were analyzed using deductive codes utilizing a conceptual framework informed by our prior work.

Results

Our participants overwhelmingly saw reproductive services as not only acceptable within OBAT but preferable to accessing these services elsewhere. Participants described the nuance of early recovery that can hinder other healthcare needs including contraception care. Participants desired reproductive counseling put into context of this recovery process and desired these counseling conversations to be with their trusted addiction care providers who “already knew their stories”.

Conclusions

Our findings provide patient-voiced support to the idea that OBAT clinics are an important access point to reproductive health services for patients with SUD. The longitudinal relationship between patients and OBAT staff minimizes stigma and provides focused knowledge on the unique reproductive concerns of these patients. Our participants provide insight into factors necessary for successful integration of family planning services to support the patient-desired idea of an addiction care medical home.