Reframing conceptualizations of primary care involvement in opioid use disorder treatment

Original research
par
Chiu, K. & Sud, A.

Date de publication

2024

Géographie

International

Langue de la ressource

English

Texte disponible en version intégrale

Oui

Open Access / OK to Reproduce

Oui

Évalué par des pairs

Yes

L’objectif

This study examined how and why primary care systems may be suited towards, or pose challenges to providing OUD care, and identified health system opportunities to address these challenges.

Constatations/points à retenir

Primary care was identified to be an ideal setting for OUD care delivery due to its potential as the first point of contact in the health system; the opportunity to provide care continuity. However, challenges include a lack of resources and support for chronic disease management more broadly in primary care, and the prevailing model of OUD treatment, where addictions care is not seen as part of comprehensive primary care. Additionally, the highly regulated OUD policy landscape is also a barrier, manifesting as a 'regulatory cascade' in which restrictive oversight of OUD treatment passes from regulators to health providers to patients, normalizing the overly restrictive nature and inaccessibility of OUD care.

La conception ou méthodologie de recherche

This study is a retrospective policy analysis, drawing on qualitative case study research methodology and using documentary analysis. Furthermore, 14 semi-structured interviews with 16 key informants with experience in opioid use policy were conducted in Canada and Australia, with hybrid deductive-inductive data analysis incorporating a theoretical framework (Starfield’s “4Cs” of primary care).

Mots clés

About prescribers
Barriers and enablers
Hesitancy of prescribers
Policy/Regulatory
Primary care
Stigma
Substitution/OAT
Transitions in care/treatment