TY - JOUR
T1 - Conceptualising retention in treatment with long-acting injectable buprenorphine (for opioid use disorder) as a journey
T2 - Findings from a longitudinal qualitative study
AU - Parkin, Stephen
AU - Neale, Joanne
AU - Strang, John
N1 - Publisher Copyright:
© 2023 The Author(s)
PY - 2023/12
Y1 - 2023/12
N2 - Background: Conceptualisations of the ‘patient journey’ are popular within health service research. Patient journeys provide a person-centred approach to health care that typically prioritise subjective patient experience with the aim of improving relevant forms of intervention. This article explores the conceptualisation of retention in treatment for opioid use disorder (OUD) using long-acting injectable buprenorphine (LAIB) as a journey. Methods: Data derive from a longitudinal qualitative study, involving semi-structured interviews (held at six time-points), with participants who each initiated LAIB for the first time. Data analysis for this article focuses exclusively upon the experiences of those who had continued with LAIB treatment throughout one year (11 participants). Framework and thematic narrative analyses of 64 interviews with 11 participants sought to identify ‘retention-narratives’ that would indicate a ‘retention journey’ associated with LAIB treatment. Findings: Shared treatment experiences consisted of three distinct phases (Withdrawal and Separation, Transformation, and Engagement) that progressed in a linear and intersecting manner through time. Each phase had features that defined treatment experiences at a given time but changed as treatment progressed. All 11 participants experienced multiple features within each of the three treatment phases and all participants reported separation from their respective service provider throughout the first 12 months of treatment. Although some valued the latter separation, most were dissatisfied by reduced levels of contact. Conclusion: Retention in treatment for OUD with LAIB, for at least 12-months, can be conceptualised as a journey. This conceptualisation emphasises the benefits (and challenges) clinicians and patients may expect to encounter during the first year of a LAIB treatment programme. An added implication of conceptualising LAIB treatment in this manner is that optimal benefits of the medication (as observed by participants) began to emerge during ‘months 7–12’ of the retention journey.
AB - Background: Conceptualisations of the ‘patient journey’ are popular within health service research. Patient journeys provide a person-centred approach to health care that typically prioritise subjective patient experience with the aim of improving relevant forms of intervention. This article explores the conceptualisation of retention in treatment for opioid use disorder (OUD) using long-acting injectable buprenorphine (LAIB) as a journey. Methods: Data derive from a longitudinal qualitative study, involving semi-structured interviews (held at six time-points), with participants who each initiated LAIB for the first time. Data analysis for this article focuses exclusively upon the experiences of those who had continued with LAIB treatment throughout one year (11 participants). Framework and thematic narrative analyses of 64 interviews with 11 participants sought to identify ‘retention-narratives’ that would indicate a ‘retention journey’ associated with LAIB treatment. Findings: Shared treatment experiences consisted of three distinct phases (Withdrawal and Separation, Transformation, and Engagement) that progressed in a linear and intersecting manner through time. Each phase had features that defined treatment experiences at a given time but changed as treatment progressed. All 11 participants experienced multiple features within each of the three treatment phases and all participants reported separation from their respective service provider throughout the first 12 months of treatment. Although some valued the latter separation, most were dissatisfied by reduced levels of contact. Conclusion: Retention in treatment for OUD with LAIB, for at least 12-months, can be conceptualised as a journey. This conceptualisation emphasises the benefits (and challenges) clinicians and patients may expect to encounter during the first year of a LAIB treatment programme. An added implication of conceptualising LAIB treatment in this manner is that optimal benefits of the medication (as observed by participants) began to emerge during ‘months 7–12’ of the retention journey.
KW - Buvidal
KW - Depot buprenorphine
KW - Longitudinal qualitative research
KW - Patient experience
KW - Retention-Narrative
KW - Touchpoints
UR - http://www.scopus.com/inward/record.url?scp=85174541202&partnerID=8YFLogxK
U2 - 10.1016/j.drugpo.2023.104221
DO - 10.1016/j.drugpo.2023.104221
M3 - Article
C2 - 37865052
AN - SCOPUS:85174541202
SN - 0955-3959
VL - 122
JO - International Journal of Drug Policy
JF - International Journal of Drug Policy
M1 - 104221
ER -