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A transition of power in opioid substitution treatment: Clinic managers' views on the consequences of a patient choice reform

Objectives: Opioid substitution treatment (OST) is often described as a strict and highly regulated treatment method, in which patients have limited influence over their treatment. In 2014, a reform was introduced by the regional council of Skåne in southern Sweden, which allowed OST patients to cho...

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Autor principal: Andersson, Lisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9152230/
https://www.ncbi.nlm.nih.gov/pubmed/35720521
http://dx.doi.org/10.1177/14550725221075003
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author Andersson, Lisa
author_facet Andersson, Lisa
author_sort Andersson, Lisa
collection PubMed
description Objectives: Opioid substitution treatment (OST) is often described as a strict and highly regulated treatment method, in which patients have limited influence over their treatment. In 2014, a reform was introduced by the regional council of Skåne in southern Sweden, which allowed OST patients to choose their treatment provider, thus transferring power from care providers to patients. The aim of this study was to examine what this increase in patient influence has meant for the clinics that provide OST in Skåne, and how these clinics have dealt with the new competitive situation that has arisen following the introduction of the reform. Methods: The study is based on two waves of semi-structured interviews with clinic managers at all OST clinics in Skåne. Results: The clinic managers described the increase in patient influence as a positive change, which had led to the patients being treated with more respect. The competition among clinics was expressed, among other things, in the form of differing views on the prescription of benzodiazepines, which initially gave rise to dissatisfaction among clinics with a more restrictive approach to such prescriptions. The reform did not lead to any clear diversity between clinics, apart from different approaches to the prescription of benzodiazepines. The incentive for competition-based diversity is, however, limited by the strict national regulatory system and by the reimbursement system, which restricts the ways in which clinics can conduct treatment activities. Conclusion: OST-clinic managers were largely positive about the increased patient empowerment and the shift in power balance associated with the patient choice reform. The introduction of the reform did not lead to any clear diversity between treatment providers, apart from differing views on the prescription of benzodiazepines, which by some managers was regarded as unfair competition.
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spelling pubmed-91522302022-06-16 A transition of power in opioid substitution treatment: Clinic managers' views on the consequences of a patient choice reform Andersson, Lisa Nordisk Alkohol Nark Research Reports Objectives: Opioid substitution treatment (OST) is often described as a strict and highly regulated treatment method, in which patients have limited influence over their treatment. In 2014, a reform was introduced by the regional council of Skåne in southern Sweden, which allowed OST patients to choose their treatment provider, thus transferring power from care providers to patients. The aim of this study was to examine what this increase in patient influence has meant for the clinics that provide OST in Skåne, and how these clinics have dealt with the new competitive situation that has arisen following the introduction of the reform. Methods: The study is based on two waves of semi-structured interviews with clinic managers at all OST clinics in Skåne. Results: The clinic managers described the increase in patient influence as a positive change, which had led to the patients being treated with more respect. The competition among clinics was expressed, among other things, in the form of differing views on the prescription of benzodiazepines, which initially gave rise to dissatisfaction among clinics with a more restrictive approach to such prescriptions. The reform did not lead to any clear diversity between clinics, apart from different approaches to the prescription of benzodiazepines. The incentive for competition-based diversity is, however, limited by the strict national regulatory system and by the reimbursement system, which restricts the ways in which clinics can conduct treatment activities. Conclusion: OST-clinic managers were largely positive about the increased patient empowerment and the shift in power balance associated with the patient choice reform. The introduction of the reform did not lead to any clear diversity between treatment providers, apart from differing views on the prescription of benzodiazepines, which by some managers was regarded as unfair competition. SAGE Publications 2022-02-01 2022-06 /pmc/articles/PMC9152230/ /pubmed/35720521 http://dx.doi.org/10.1177/14550725221075003 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Research Reports
Andersson, Lisa
A transition of power in opioid substitution treatment: Clinic managers' views on the consequences of a patient choice reform
title A transition of power in opioid substitution treatment: Clinic managers' views on the consequences of a patient choice reform
title_full A transition of power in opioid substitution treatment: Clinic managers' views on the consequences of a patient choice reform
title_fullStr A transition of power in opioid substitution treatment: Clinic managers' views on the consequences of a patient choice reform
title_full_unstemmed A transition of power in opioid substitution treatment: Clinic managers' views on the consequences of a patient choice reform
title_short A transition of power in opioid substitution treatment: Clinic managers' views on the consequences of a patient choice reform
title_sort transition of power in opioid substitution treatment: clinic managers' views on the consequences of a patient choice reform
topic Research Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9152230/
https://www.ncbi.nlm.nih.gov/pubmed/35720521
http://dx.doi.org/10.1177/14550725221075003
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