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Exploring Preferences for Communication and Care Among Hospitalized Patients With Opioid Use Disorder: A Qualitative
M Holliday Davis1, Rachel French, Molly Crowe
1Center for Addiction Medicine and Policy, University of Pennsylvania, Philadelphia, PA (MHD); Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (MHD); School of Nursing, University of Pennsylvania, Philadelphia, PA (MHD); National Clinician Scholars Program, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA (RF); Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA (RF); Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (MC); Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (MA); College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA (GE); Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA (SA); School of Nursing, University of Pennsylvania, Philadelphia, PA (SA); Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA (DSM); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (DSM); Research Director, Center for Addiction Medicine and Policy, University of Pennsylvania, Philadelphia, PA (ML); Leonard Davis Institute for Health Economics, University of Pennsylvania, 3641 Locust Walk, Philadelphia, PA (ML); and Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (ML).
Objective:
The aim of the study was to explore hospitalized patient priorities for effective communication and care in opioid use disorder (OUD).
Methods:
In this qualitative descriptive study, we conducted semistructured interviews from April to August 2022 focusing on communication values with inpatient care teams among hospitalized patients with OUD in Philadelphia, PA. Interviews were recorded, transcribed, and analyzed with thematic content analysis.
Results:
We identified 3 key themes in the communication and care planning preferences of the 21 patients we interviewed: effectiveness, reciprocity, and empathy. Patients emphasized the need for clear, reliable, and frequent communication from healthcare providers, valuing collaborative dialog, shared decision making, and empathic nonstigmatized interactions that incorporated their prior experiences, full personhood, and current symptoms. Participants reported negative experiences with inconsistent or dismissive communication but appreciated care that incorporated their input and was nonjudgmental, fostering a sense of trust in their healthcare teams.
Conclusions:
Effective, empathic communication, and shared decision making were favored by hospitalized patients with OUD and may be a way to improve treatment for hospitalized patients with OUD. Our findings underscore the need for stigma reduction strategies in clinical education and the expansion of both generalist resources for the treatment of OUD and specialized addiction care services.
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