Bradbury, M;
Lewer, D;
(2021)
Role of community drug and alcohol services in physical healthcare for people who use illicit opioids: a qualitative study of clinical staff in the UK.
BMJ Open
, 11
(7)
, Article e046577. 10.1136/bmjopen-2020-046577.
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Abstract
Objectives: To understand how clinicians working in addiction services perceive their responsibilities for physical healthcare of clients who use opioids, and how physical healthcare could be improved for this group. Design: Qualitative study comprising semistructured interviews. Participants: 16 clinicians, including nurses and nurse practitioners, nurse consultants, addiction psychiatrists, specialist general practitioners and psychiatry specialty registrars. Setting Community-based drug and alcohol treatment services in the UK, with services including outpatient opioid agonist therapy. Results: We identified three overarching themes. First, clients have unmet physical health needs that are often first identified in community drug and alcohol services. Participants reported attempts to improve their clients’ access to healthcare by liaising directly with health services and undertaking other forms of health advocacy, but report limited success, with many referrals ending in non-attendance. Second, most participants saw their role as supporting access to mainstream health services rather than providing physical healthcare directly, though sometimes reported frustration at being unable to provide certain treatments such as antibiotics for a respiratory infection. A minority of participants felt that people who use illicit opioids would be best served by an integrated ‘one-stop-shop’ model, but felt this model is currently unlikely to receive funding. Third, participants felt isolated from other health services, in part due to commissioning arrangements in which funding is provided through local government rather than the National Health Service. Conclusions: Clinicians participating in this study serve a patient group with unmet physical health needs, but lack the resources to respond effectively to these needs.
| Type: | Article |
|---|---|
| Title: | Role of community drug and alcohol services in physical healthcare for people who use illicit opioids: a qualitative study of clinical staff in the UK |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/bmjopen-2020-046577 |
| Publisher version: | https://doi.org/10.1136/bmjopen-2020-046577 |
| Language: | English |
| Additional information: | This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | adult psychiatry, organisation of health services, primary care, public health, qualitative research, substance misuse |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10132261 |
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