Cross-analyzing addiction specialist and patient opinions and experiences about addictive disorder screening in primary care to identify interaction-related obstacles: a qualitative study.
Addiction specialist
Addictive disorders
Early detection
Interprofessional collaboration
Mass screening
Patient-centered approach
Primary health care
Psychological barriers
Self-disclosure
Substance use disorder
Journal
Substance abuse treatment, prevention, and policy
ISSN: 1747-597X
Titre abrégé: Subst Abuse Treat Prev Policy
Pays: England
ID NLM: 101258060
Informations de publication
Date de publication:
17 02 2023
17 02 2023
Historique:
received:
15
11
2022
accepted:
04
02
2023
entrez:
21
2
2023
pubmed:
22
2
2023
medline:
25
2
2023
Statut:
epublish
Résumé
Promptly identifying individuals with addictive disorders reduces mortality and morbidity and improves quality of life. Although screening in primary care with the Screening, Brief Intervention and Referral Treatment strategy has been recommended since 2008, it remains underutilized. This may be due to barriers including lack of time, patient reluctance or perhaps the timing and approach for discussing addiction with their patients. This study aims to explore and cross-analyze patient and addiction specialist experiences and opinions about early addictive disorder screening in primary care to identify interaction-related screening obstacles. Qualitative study with purposive maximum variation sampling among nine addiction specialists and eight individuals with addiction disorders conducted between April 2017 and November 2019 in Val-de-Loire, France. Using a grounded theory approach, verbatim data was collected from face-to-face interviews with addiction specialists and individuals with addiction disorders. These interviews explored their opinions and experiences with addiction screening in primary care. Initially, two independent investigators analyzed the coded verbatim according to the data triangulation principle. Secondly, convergences and divergences between addiction specialist and addict verbatim categories were identified, analyzed, and conceptualized. Four main interaction-related obstacles to early addictive disorder screening in primary care were identified and conceptualized: the new concepts of shared self-censorship and the patient's personal red line, issues not addressed during consultations, and opposition between how physicians and patients would like to approach addictive disorder screening. To continue analysis of addictive disorder screening dynamics, further studies to examine the perspectives of all those involved in primary care are required. The information revealed from these studies will provide ideas to help patients and caregivers start discussing addiction and to help implement a collaborative team-based care approach. This study is registered with the Commission Nationale de l'Informatique et des Libertés (CNIL) under No. 2017-093.
Sections du résumé
BACKGROUND
Promptly identifying individuals with addictive disorders reduces mortality and morbidity and improves quality of life. Although screening in primary care with the Screening, Brief Intervention and Referral Treatment strategy has been recommended since 2008, it remains underutilized. This may be due to barriers including lack of time, patient reluctance or perhaps the timing and approach for discussing addiction with their patients.
OBJECTIVE
This study aims to explore and cross-analyze patient and addiction specialist experiences and opinions about early addictive disorder screening in primary care to identify interaction-related screening obstacles.
DESIGN AND PARTICIPANTS
Qualitative study with purposive maximum variation sampling among nine addiction specialists and eight individuals with addiction disorders conducted between April 2017 and November 2019 in Val-de-Loire, France.
MAIN MEASURES
Using a grounded theory approach, verbatim data was collected from face-to-face interviews with addiction specialists and individuals with addiction disorders. These interviews explored their opinions and experiences with addiction screening in primary care. Initially, two independent investigators analyzed the coded verbatim according to the data triangulation principle. Secondly, convergences and divergences between addiction specialist and addict verbatim categories were identified, analyzed, and conceptualized.
KEY RESULTS
Four main interaction-related obstacles to early addictive disorder screening in primary care were identified and conceptualized: the new concepts of shared self-censorship and the patient's personal red line, issues not addressed during consultations, and opposition between how physicians and patients would like to approach addictive disorder screening.
CONCLUSIONS
To continue analysis of addictive disorder screening dynamics, further studies to examine the perspectives of all those involved in primary care are required. The information revealed from these studies will provide ideas to help patients and caregivers start discussing addiction and to help implement a collaborative team-based care approach.
TRIAL REGISTRATION
This study is registered with the Commission Nationale de l'Informatique et des Libertés (CNIL) under No. 2017-093.
Identifiants
pubmed: 36803797
doi: 10.1186/s13011-023-00522-5
pii: 10.1186/s13011-023-00522-5
pmc: PMC9938560
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
12Informations de copyright
© 2023. The Author(s).
Références
Med Care. 1993 Apr;31(4):285-95
pubmed: 8464246
Subst Abus. 2007;28(3):7-30
pubmed: 18077300
Drug Alcohol Depend. 2007 Jan 12;86(2-3):214-21
pubmed: 16919401
Soc Sci Med. 2000 May;50(10):1501-10
pubmed: 10741584
Patient Educ Couns. 2016 Jul;99(7):1138-1145
pubmed: 26830544
J Addict Med. 2018 Jul/Aug;12(4):262-272
pubmed: 30063221
J Addict Dis. 2008;27(3):77-97
pubmed: 18956531
Transcult Psychiatry. 2006 Dec;43(4):671-91
pubmed: 17166953
Subst Abuse Treat Prev Policy. 2019 Sep 11;14(1):37
pubmed: 31511016
Int J Drug Policy. 2010 Sep;21(5):364-80
pubmed: 20172706
Drug Alcohol Rev. 2017 Sep;36(5):578-588
pubmed: 28334460
Subst Abus. 2020;41(4):519-525
pubmed: 31638862
J Gen Intern Med. 2019 Dec;34(12):2824-2832
pubmed: 31414355
Am J Public Health. 2003 Apr;93(4):635-41
pubmed: 12660210
Addict Sci Clin Pract. 2018 Apr 9;13(1):8
pubmed: 29628018
Qual Health Res. 2004 Sep;14(7):976-93
pubmed: 15296667
J Stud Alcohol Drugs. 2021 Mar;82(2):269-278
pubmed: 33823974
J Eat Disord. 2021 Oct 30;9(1):142
pubmed: 34717760
Drug Alcohol Depend. 2014 Sep 1;142:254-61
pubmed: 25042213
J Psychoactive Drugs. 2012 Sep-Oct;44(4):307-17
pubmed: 23210379
Rev Esp Salud Publica. 2021 May 19;95:
pubmed: 34009189
Addiction. 2017 Feb;112 Suppl 2:43-53
pubmed: 28074561
J Subst Abuse Treat. 2000 Mar;18(2):193-202
pubmed: 10716103
Addiction. 2017 Feb;112 Suppl 2:110-117
pubmed: 28074569
Lancet Psychiatry. 2019 Dec;6(12):1054-1067
pubmed: 31630982
Psychiatry Res. 2017 Jun;252:208-214
pubmed: 28285247
Gen Psychiatr. 2021 Sep 24;34(5):e100486
pubmed: 34651102
J Anxiety Disord. 2018 Apr;55:14-21
pubmed: 29550689
Drug Alcohol Depend. 2018 Dec 1;193:1-6
pubmed: 30321739
Bull World Health Organ. 2019 Dec 1;97(12):846-848
pubmed: 31819293
Addict Sci Clin Pract. 2011 Jul;6(1):44-55
pubmed: 22003421
J Prim Health Care. 2012 Sep 01;4(3):217-22
pubmed: 22946070
Addict Behav. 2022 Mar;126:107180
pubmed: 34864478
Eur J Emerg Med. 2021 Oct 01;28(5):373-379
pubmed: 33709997
Nursing. 2021 Mar 1;51(3):63-66
pubmed: 33674539
Ther Umsch. 2014 Oct;71(10):585-91
pubmed: 25257112
Soins Psychiatr. 2019 Mar - Apr;40(321):41-44
pubmed: 31006444