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Sorting through life: evaluating patient-important measures of success in a medication for opioid use disorder (MOUD) treatment program

BACKGROUND: Medication for opioid use disorder (MOUD) is the gold standard treatment for opioid use disorder. Traditionally, “success” in MOUD treatment is measured in terms of program retention, adherence to MOUD, and abstinence from opioid and other drug use. While clinically meaningful, these met...

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Autores principales: Reed, Megan K., Smith, Kelsey R., Ciocco, Francesca, Hass, Richard W., Cox, Avery Lin, Kelly, Erin L., Weinstein, Lara C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9839958/
https://www.ncbi.nlm.nih.gov/pubmed/36641478
http://dx.doi.org/10.1186/s13011-022-00510-1
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author Reed, Megan K.
Smith, Kelsey R.
Ciocco, Francesca
Hass, Richard W.
Cox, Avery Lin
Kelly, Erin L.
Weinstein, Lara C.
author_facet Reed, Megan K.
Smith, Kelsey R.
Ciocco, Francesca
Hass, Richard W.
Cox, Avery Lin
Kelly, Erin L.
Weinstein, Lara C.
author_sort Reed, Megan K.
collection PubMed
description BACKGROUND: Medication for opioid use disorder (MOUD) is the gold standard treatment for opioid use disorder. Traditionally, “success” in MOUD treatment is measured in terms of program retention, adherence to MOUD, and abstinence from opioid and other drug use. While clinically meaningful, these metrics may overlook other aspects of the lives of people with opioid use disorder (OUD) and surprisingly do not reflect the diagnostic criteria for OUD. METHODS: Authors identified items for a pilesorting task to identify participant-driven measures of MOUD treatment success through semi-structured interviews. Interviews were transcribed verbatim and coded in Nvivo using directed and conventional content analysis to identify measures related to treatment success and quality of life goals. Participants of a low-threshold MOUD program were recruited and asked to rank identified measures in order of importance to their own lives. Multidimensional scaling (MDS) compared the similarity of items while non-metric MDS in R specified a two-dimensional solution. Descriptive statistics of participant demographics were generated in SPSS. RESULTS: Sixteen semi-structured interviews were conducted between June and August 2020 in Philadelphia, PA, USA, and 23 measures were identified for a pilesorting activity. These were combined with 6 traditional measures for a total list of 29 items. Data from 28 people were included in pilesorting analysis. Participants identified a combination of traditional and stakeholder-defined recovery goals as highly important, however, we identified discrepancies between the most frequent and highest ranked items within the importance categories. Measures of success for participants in MOUD programs were complex, multi-dimensional, and varied by the individual. However, some key domains such as emotional well-being, decreased drug use, and attendance to basic functioning may have universal importance. The following clusters of importance were identified: emotional well-being, decreased drug use, and human functioning. CONCLUSIONS: Outcomes from this research have practical applications for those working to provide services in MOUD programs. Programs can use aspects of these domains to both provide patient-centered care and to evaluate success. Specifics from the pilesorting results may also inform approaches to collaborative goal setting during treatment.
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spelling pubmed-98399582023-01-15 Sorting through life: evaluating patient-important measures of success in a medication for opioid use disorder (MOUD) treatment program Reed, Megan K. Smith, Kelsey R. Ciocco, Francesca Hass, Richard W. Cox, Avery Lin Kelly, Erin L. Weinstein, Lara C. Subst Abuse Treat Prev Policy Research BACKGROUND: Medication for opioid use disorder (MOUD) is the gold standard treatment for opioid use disorder. Traditionally, “success” in MOUD treatment is measured in terms of program retention, adherence to MOUD, and abstinence from opioid and other drug use. While clinically meaningful, these metrics may overlook other aspects of the lives of people with opioid use disorder (OUD) and surprisingly do not reflect the diagnostic criteria for OUD. METHODS: Authors identified items for a pilesorting task to identify participant-driven measures of MOUD treatment success through semi-structured interviews. Interviews were transcribed verbatim and coded in Nvivo using directed and conventional content analysis to identify measures related to treatment success and quality of life goals. Participants of a low-threshold MOUD program were recruited and asked to rank identified measures in order of importance to their own lives. Multidimensional scaling (MDS) compared the similarity of items while non-metric MDS in R specified a two-dimensional solution. Descriptive statistics of participant demographics were generated in SPSS. RESULTS: Sixteen semi-structured interviews were conducted between June and August 2020 in Philadelphia, PA, USA, and 23 measures were identified for a pilesorting activity. These were combined with 6 traditional measures for a total list of 29 items. Data from 28 people were included in pilesorting analysis. Participants identified a combination of traditional and stakeholder-defined recovery goals as highly important, however, we identified discrepancies between the most frequent and highest ranked items within the importance categories. Measures of success for participants in MOUD programs were complex, multi-dimensional, and varied by the individual. However, some key domains such as emotional well-being, decreased drug use, and attendance to basic functioning may have universal importance. The following clusters of importance were identified: emotional well-being, decreased drug use, and human functioning. CONCLUSIONS: Outcomes from this research have practical applications for those working to provide services in MOUD programs. Programs can use aspects of these domains to both provide patient-centered care and to evaluate success. Specifics from the pilesorting results may also inform approaches to collaborative goal setting during treatment. BioMed Central 2023-01-14 /pmc/articles/PMC9839958/ /pubmed/36641478 http://dx.doi.org/10.1186/s13011-022-00510-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Reed, Megan K.
Smith, Kelsey R.
Ciocco, Francesca
Hass, Richard W.
Cox, Avery Lin
Kelly, Erin L.
Weinstein, Lara C.
Sorting through life: evaluating patient-important measures of success in a medication for opioid use disorder (MOUD) treatment program
title Sorting through life: evaluating patient-important measures of success in a medication for opioid use disorder (MOUD) treatment program
title_full Sorting through life: evaluating patient-important measures of success in a medication for opioid use disorder (MOUD) treatment program
title_fullStr Sorting through life: evaluating patient-important measures of success in a medication for opioid use disorder (MOUD) treatment program
title_full_unstemmed Sorting through life: evaluating patient-important measures of success in a medication for opioid use disorder (MOUD) treatment program
title_short Sorting through life: evaluating patient-important measures of success in a medication for opioid use disorder (MOUD) treatment program
title_sort sorting through life: evaluating patient-important measures of success in a medication for opioid use disorder (moud) treatment program
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9839958/
https://www.ncbi.nlm.nih.gov/pubmed/36641478
http://dx.doi.org/10.1186/s13011-022-00510-1
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