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Decrease in provider stigma is associated with improved quality health indicators among individuals receiving

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Integrating methadone into primary care reduced provider stigma and improved patient health outcomes. This approach enhances access to essential services for people who inject drugs.

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HIVImplementation scienceIntegrated careMethadoneOpioid agonist therapies (OAT)People who inject drugs (PWID)Stigma

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Area of Science:

  • Public Health
  • Addiction Medicine
  • Healthcare Implementation

Background:

  • People who inject drugs face significant health disparities, often exacerbated by provider stigma, impacting their access to care.
  • Opioid agonist therapies, such as methadone, improve outcomes for people who inject drugs, but healthcare utilization remains a challenge.
  • Integrating methadone into primary care centers (PCCs) in Ukraine offers a unique setting to study provider stigma and its effects.

Purpose of the Study:

  • To assess the impact of integrating methadone into primary care on provider stigma towards people who inject drugs.
  • To examine the association between reduced provider stigma and patient health outcomes in Ukraine.
  • To evaluate the effectiveness of tele-education in mitigating provider stigma within PCCs.

Main Methods:

  • A sub-analysis of an implementation trial involving patients receiving methadone in PCCs versus specialty addiction clinics.
  • Provider stigma, attitudes towards evidence-based practices, and patient quality health indicator (QHI) scores were assessed over 24 months.
  • Linear mixed-effects models were used to analyze changes in stigma and their correlation with patient outcomes.

Main Results:

  • Provider fear and stereotypes towards people who inject drugs significantly improved post-integration.
  • Improvements in provider prejudice and attitudes towards evidence-based practices correlated with increased patient primary care QHI scores.
  • Reduced stereotypes and preference for methadone maintenance were associated with significant increases in patient specialty care QHI scores.

Conclusions:

  • Integrating methadone into PCCs, supported by tele-education, effectively reduces provider stigma, including fear and stereotypes.
  • Lower provider stigma is linked to improved patient access to primary and specialty healthcare services.
  • This integration model holds potential for enhancing preventive care and screenings for people who inject drugs.