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Article
Patients Reasons for Choosing Office-based Buprenorphine: Preference for Patient-Centered Care
Social Work Faculty Publications and Presentations
  • P. Todd Korthuis
  • Jessica Gregg
  • Wendy E. Rogers
  • Dennis McCarty
  • Christina Nicolaidis, Portland State University
  • Joshua Boverman
Document Type
Article
Publication Date
12-1-2010
Subjects
  • Opioid abuse -- Treatment,
  • Buprenorphine -- Therapeutic use,
  • Patient participation,
  • Medical personnel and patient
Disciplines
Abstract
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.
Description

This is the author's version of a work accepted for publication. The final publication is available at http://journals.lww.com/

DOI
10.1097/ADM.0b013e3181cc9610
Persistent Identifier
http://archives.pdx.edu/ds/psu/9498
Citation Information
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