Accepted for/Published in: JMIR Formative Research
Date Submitted: Jul 8, 2022
Open Peer Review Period: Jul 8, 2022 - Sep 2, 2022
Date Accepted: Mar 23, 2023
(closed for review but you can still tweet)
Patient-Centered Outcomes associated with a Novel Office-Based Opioid Treatment Program in a District Health Department: A Mixed-Method Pilot Study
ABSTRACT
Background:
Granville and Vance counties have some of the highest opioid-related death rates in North Carolina, and have significant unmet needs with regard to opioid treatment. In order to connect patients with needed medication for opioid use disorder (MOUD) services, the district health department, Granville Vance Public Health (GVPH), established an office-based opioid treatment (OBOT) program.
Objective:
In this formative pilot study, we sought to describe patients’ goals and outcomes in a program delivered at a rural local health department using an integrated care approach.
Methods:
We used a mixed-methods concurrent nested research design. The primary method of investigation was one-on-one qualitative interviews with active OBOT patients (n=7) focused on patients’ goals and perceived impacts of the program. The secondary method was a descriptive quantitative analysis (n=79 patients; 1478 visits over 2.5 years) of treatment retention, and patient-reported outcomes.
Results:
Participants in the OBOT program were 39.6 years old on average, and 25.3% were uninsured. Average retention in the program was 18.4 months. The proportion of individuals in the program with moderate-to-severe depression (Patient Health Questionnaire-9 scores ≥10) at program initiation was 66%, and at the most-recent assessment, reduced to 34%. Patients credited the OBOT program for reductions in use of opioids and other substances, and improvements in quality of life.
Conclusions:
Initial data show promising patient outcomes for active GVPH OBOT participants, including reduction in opioid use and improvements in quality of life. As a pilot study, a limitation of this study is a lack of a comparison group. However, this formative project demonstrates promising patient-centered outcome improvements for GVPH OBOT participants. Clinical Trial: n/a
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