Supported by the Health Research and Services Administration, Special Projects of National Significance (1-H97- HA03782-01), and the National Institutes of Health, National Institute on Drug Abuse (K23DA019808 and R01DA016341). Dr. Gregg’s time was supported by the Oregon Clinical and Translational Research Institute (OCTRI), grant number UL1 RR024140 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Dr. Nicolaidis’ time was supported by the National Institute of Mental Health (K23MH073008).
Opioid abuse -- Treatment, Buprenorphine -- Therapeutic use, Patient participation, Medical personnel and patient
Objectives - To explore HIV-infected patients' attitudes about buprenorphine treatment in office-based and opioid treatment program (OTP) settings. Methods - We conducted in-depth qualitative interviews with 29 patients with co-existing HIV infection and opioid dependence seeking buprenorphine maintenance therapy in office-based and OTP settings. We used thematic analysis of transcribed audiorecorded interviews to identify themes. Results - Patients voiced a strong preference for office-based treatment. Four themes emerged to explain this preference. First, patients perceived the greater convenience of office-based treatment as improving their ability to address HIV and other healthcare issues. Second, they perceived a strong patient-focused orientation in patient-provider relationships underpinning their preference for office-based care. This was manifest as increased trust, listening, empathy, and respect from office-based staff and providers. Third, they perceived shared power and responsibility in officebased settings. Finally, patients viewed office-based treatment as a more supportive environment for sobriety and relapse prevention. This was partly due to strong therapeutic alliances with office-based staff and providers who prioritized a harm reduction approach, but also due to the perception that the office-based settings were "safer" for sobriety, compared with increased opportunities for purchasing and using illicit opiates in OTP settings. Conclusions - HIV-infected patients with opioid dependence preferred office-based buprenorphine because they perceived it as offering a more patient-centered approach to care compared with OTP referral. Office-based buprenorphine may facilitate engagement in care for patients with co-existing opioid dependence and HIV infection.
Korthuis PT, Gregg J, Rogers WE, McCarty D, Nicolaidis C, Boverman J., "Patients' Reasons for Choosing Office-based Buprenorphine: Preference for Patient-Centered Care" (2005). Journal of Addiction Medicine, 4(4): 204-10. doi: 10.1097/ADM.0b013e3181cc9610