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Sharing control: user involvement in general practice based methadone maintenance.

Fiona O'Reilly1, David O'Connell2, Austin O'Carroll3

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Summary
This summary is machine-generated.

Patients in a Dublin general practice methadone program felt heard regarding their treatment decisions, but desired more structured involvement. Many patients successfully reduced or stopped heroin use while on methadone.

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Area of Science:

  • General Practice
  • Addiction Medicine
  • Patient-Centered Care

Background:

  • Methadone maintenance treatment is a cornerstone of opioid addiction management.
  • Patient involvement in treatment decisions is increasingly recognized as crucial for therapeutic success.
  • Understanding patient perspectives within general practice settings is vital for optimizing care.

Purpose of the Study:

  • To assess patient views on a methadone program in a Dublin general practice.
  • To determine the extent of patient involvement in treatment decisions.
  • To explore patient experiences and desires regarding methadone therapy.

Main Methods:

  • A questionnaire with open and closed questions was administered to patients in a general practice methadone service.
  • Face-to-face interviews were conducted, lasting approximately 30 minutes.
  • Quantitative data were analyzed using descriptive statistics, and qualitative data using a thematic approach.

Main Results:

  • 69% of patients who previously used heroin stopped, and 31% reduced use after starting methadone.
  • 71% of patients felt involved (always or sometimes) in decisions about their treatment, often interpreted as "being listened to" or "having a say" in methadone dosage.
  • Surprisingly, patients reporting less involvement were more likely to have stopped heroin use.

Conclusions:

  • While patients felt heard regarding methadone dosage, they lacked opportunities for more structured involvement, such as written care plans.
  • A patient-centered approach necessitates moving beyond safe methadone delivery to align services with patient goals, expectations, and choices.
  • Future efforts should focus on enhancing patient engagement in treatment planning within methadone programs.