CK is supported by grants from the National Institutes of Health, National Institute on Drug Abuse (UG1DA015815 / R01DA037441) and HE is supported by grants from National Institute on Drug Abuse (UG1DA015815). IMPACT is funded by Oregon Health & Science University and CareOregon. This publication was made possible with support from the Oregon Clinical and Translational Research Institute (OCTRI), grant number UL1TR002369 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research.
Journal of Addiction Medicine
Social Work, Substance Related Disorders, Substance abuse -- Treatment
Background: Trust is essential in patient-physician relationships. Hospitalized patients with substance use disorders (SUDs) often experience stigma and trauma in the hospital, which can impede trust. Little research has explored the role of hospital-based addictions care in creating trusting relationships with patients with SUDs. This study describes how trust in physicians changed among hospitalized people with SUDs who were seen by an interprofessional addiction medicine service.
Methods: We analyzed data from hospitalized patients with SUD seen by an addiction consult service from 2015 to 2018. Participants completed surveys at baseline and 30 to 90 days after hospital discharge. Follow-up assessments included open-ended questions exploring participant experiences with hospitalization and the addiction consult service. We measured provider trust using the Wake Forest Trust scale. We modeled trust trajectories using discrete mixture modeling, and sampled qualitative interviews from those trust trajectories.
Results: Of 328 participants with SUD who had prior hospitalizations but had not previously been seen by an addiction consult service, 196 (59.8%) had both baseline and follow-up trust scores. We identified 3 groups of patients: Persistent-Low Trust, Increasing Trust, and Persistent-High Trust and 4 qualitative themes around in-hospital trust: humanizing care, demonstrating addiction expertise, reliability, and granting agency.
Conclusions: Most participants retained or increased to high trust levels after hospitalization with an addiction consult service. Addiction consult services can create environments where healthcare providers build trust with, and humanize care for, hospitalized patients with SUD, and can also mitigate power struggles that hospitalized patients with SUD frequently experience.
© 2021 American Society of Addiction Medicine
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Locate the Document
The final, formatted version of this paper is available at: https://doi.org/10.1097/ADM.0000000000000819
Published as: King, C., Collins, D., Patten, A., Nicolaidis, C., & Englander, H. (2021). Trust in Hospital Physicians Among Patients With Substance Use Disorder Referred to an Addiction Consult Service: A Mixed-methods Study. Journal of Addiction Medicine.
Available for download on Wednesday, February 09, 2022