Experiences Using a Multidisciplinary Model for Treating Injection Drug Use Associated Infections: A Qualitative Study.
AMA discharge
medications for opioid use disorder
opioid use disorder
persons who inject drugs
substance use disorder
Journal
Frontiers in psychiatry
ISSN: 1664-0640
Titre abrégé: Front Psychiatry
Pays: Switzerland
ID NLM: 101545006
Informations de publication
Date de publication:
2022
2022
Historique:
received:
20
04
2022
accepted:
24
05
2022
entrez:
8
7
2022
pubmed:
9
7
2022
medline:
9
7
2022
Statut:
epublish
Résumé
Over the past two decades, the United States has experienced a dramatic increase in the rate of injection drug use, injection associated infections, and overdose mortality. A hospital-based program for treating opioid use disorder in people who inject drugs presenting with invasive infections was initiated at an academic tertiary care center in 2020. The goal of this program was to improve care outcomes, enhance patient experiences, and facilitate transition from the hospital to longer term addiction care. The purpose of this study was to interview two cohorts of patients, those admitted before vs. after initiation of this program, to understand the program's impact on care from the patient's perspective and explore ways in which the program could be improved. Thirty patients admitted to the hospital with infectious complications of injection drug use were interviewed using a semi-structured format. Interviews were transcribed and coded. Emergent themes were reported. Limited descriptive statistics were reported based on chart review. Thirty interviews were completed; 16 participants were part of the program (admitted after program implementation) while 14 were not participants (admitted prior to implementation). Common themes associated with hospitalization included inadequate pain control, access to medications for opioid use disorder (MOUD), loss of freedom, stigma from healthcare personnel, and benefits of having an interprofessional team. Participants in the program were more likely to report adequate pain control and access to MOUD and many cited benefits from receiving care from an interprofessional team. Patients with opioid use disorder admitted with injection related infections reported improved experiences when receiving care from an interprofessional team focused on their addiction. However, perceived stigma from healthcare personnel and loss of freedom related to hospitalization were continued barriers to care before and after implementation of this program.
Sections du résumé
Background
UNASSIGNED
Over the past two decades, the United States has experienced a dramatic increase in the rate of injection drug use, injection associated infections, and overdose mortality. A hospital-based program for treating opioid use disorder in people who inject drugs presenting with invasive infections was initiated at an academic tertiary care center in 2020. The goal of this program was to improve care outcomes, enhance patient experiences, and facilitate transition from the hospital to longer term addiction care. The purpose of this study was to interview two cohorts of patients, those admitted before vs. after initiation of this program, to understand the program's impact on care from the patient's perspective and explore ways in which the program could be improved.
Methods
UNASSIGNED
Thirty patients admitted to the hospital with infectious complications of injection drug use were interviewed using a semi-structured format. Interviews were transcribed and coded. Emergent themes were reported. Limited descriptive statistics were reported based on chart review.
Results
UNASSIGNED
Thirty interviews were completed; 16 participants were part of the program (admitted after program implementation) while 14 were not participants (admitted prior to implementation). Common themes associated with hospitalization included inadequate pain control, access to medications for opioid use disorder (MOUD), loss of freedom, stigma from healthcare personnel, and benefits of having an interprofessional team. Participants in the program were more likely to report adequate pain control and access to MOUD and many cited benefits from receiving care from an interprofessional team.
Conclusions
UNASSIGNED
Patients with opioid use disorder admitted with injection related infections reported improved experiences when receiving care from an interprofessional team focused on their addiction. However, perceived stigma from healthcare personnel and loss of freedom related to hospitalization were continued barriers to care before and after implementation of this program.
Identifiants
pubmed: 35800016
doi: 10.3389/fpsyt.2022.924672
pmc: PMC9253819
doi:
Types de publication
Journal Article
Langues
eng
Pagination
924672Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR002345
Pays : United States
Informations de copyright
Copyright © 2022 Nolan, Gleason, Marks, Habrock-Bach, Liang and Durkin.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
JAMA Netw Open. 2020 Feb 5;3(2):e1920622
pubmed: 32022884
Int J Drug Policy. 2018 Jul;57:104-110
pubmed: 29715589
Harm Reduct J. 2020 Jul 31;17(1):53
pubmed: 32736624
Drug Alcohol Rev. 2015 Mar;34(2):221-8
pubmed: 25521168
Ann Intern Med. 2018 Aug 7;169(3):137-145
pubmed: 29913516
N Engl J Med. 2016 Jul 21;375(3):229-39
pubmed: 27468059
Pain Res Manag. 2015 Mar-Apr;20(2):84-8
pubmed: 25562839
J Gen Intern Med. 2017 Aug;32(8):909-916
pubmed: 28526932
Open Forum Infect Dis. 2022 Jan 06;9(2):ofab633
pubmed: 35106316
Drug Alcohol Depend. 2019 May 1;198:80-86
pubmed: 30884432
JAMA Netw Open. 2020 Oct 1;3(10):e2016228
pubmed: 33052402
Addiction. 2016 Dec;111(12):2079-2081
pubmed: 27412876
Clin Infect Dis. 2019 May 17;68(11):1935-1937
pubmed: 30357363
Ann Intern Med. 2018 Sep 4;169(5):335-336
pubmed: 30007032
J Addict Med. 2022 Mar-Apr 01;16(2):e133-e136
pubmed: 33840774
PLoS One. 2020 Nov 9;15(11):e0242165
pubmed: 33166363
Open Forum Infect Dis. 2021 Nov 10;9(1):ofab541
pubmed: 34988248
Acad Psychiatry. 2016 Jun;40(3):475-80
pubmed: 27056051
MMWR Morb Mortal Wkly Rep. 2017 Jun 09;66(22):569-573
pubmed: 28594786
Clin Infect Dis. 2012 Jul;55 Suppl 1:S3-9
pubmed: 22715211
J Addict Med. 2021 Apr 1;15(2):155-158
pubmed: 32804690
Health Aff (Millwood). 2016 May 1;35(5):832-7
pubmed: 27140989
Front Public Health. 2017 Jul 18;5:180
pubmed: 28770195
Int J Qual Health Care. 2007 Dec;19(6):349-57
pubmed: 17872937
Int J Drug Policy. 2021 Aug;94:103206
pubmed: 33765516
MMWR Morb Mortal Wkly Rep. 2021 Dec 17;70(50):1740-1746
pubmed: 34914673
J Infect Dis. 2020 Sep 2;222(Suppl 5):S513-S520
pubmed: 32877547
Healthc Manage Forum. 2016 May;29(3):116-20
pubmed: 27060804
BMC Infect Dis. 2021 Aug 9;21(1):772
pubmed: 34372776
J Addict Behav Ther Rehabil. 2013 May 27;2(2):
pubmed: 25401117
Open Forum Infect Dis. 2021 May 29;8(6):ofab285
pubmed: 34189180
J Infect Dis. 2020 Sep 2;222(Suppl 5):S499-S505
pubmed: 32877555