Development of Best Practice Guidelines for Primary Care to Support Patients Who Use Substances

INTRODUCTION: People who use substances often mistrust the primary care system, impeding access. OBJECTIVES: To build on research clarifying how to improve patients’ feelings of safety, through co-creating best practice guidelines with physicians and patient representatives. METHODS: After obtaining Research Ethics Board approval, this qualitative study engaged 22 participants including patients, physicians, and health system partners. We held a series of workshops, co-facilitated by patients and researchers, corresponding to 3 phases of the research: (1) establishment of cultural safety processes for participants during the workshops; (2) a facilitated, collaborative world café to develop guideline content; (3) validation of best practice guidelines. An implementation plan was developed and implemented. Finally, an external peer review was conducted by McGill University. RESULTS: Best practices guidelines were developed giving the patient perspective on how to enhance primary care, as follows: (1) become trauma informed; (2) consider your clinical environment; (3) build a network; (4) supply an array of resources; (5) co-create a long-term treatment plan; (6) help me to stay healthy; (7) ensure timely access to specialized medical and surgical care; (8) be an advocate; (9) ask for feedback; (10) follow up. Resources were developed and disseminated. CONCLUSION: The best practice guidelines reflect the patients’ perspectives on common challenges patients have encountered, which impede their access to primary care. They support primary care physicians in providing more effective services to this challenging population of patients.