A chance to stop and breathe: participants’ experiences in the North American Opiate Medication Initiative clinical trial

Addiction Science & Clinical Practice

Eugenia Oviedo-Joekes¹  Kirsten Marchand¹  Kurt Lock⁴  Jill Chettiar¹  David C Marsh²  Suzanne Brissette³  Aslam H Anis¹  Martin T Schechter¹ 

[1] School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada

[2] Northern Ontario School of Medicine, 955 Oliver Road, Thunder Bay, ON P7B 5E1, Canada

[3] Centre Hospitalier de l’Université de Montréal, Hôpital Saint-Luc, CHUM Montréal, QC, Montréal H2X 3J4, Canada

[4] Centre for Health Evaluation & Outcome Sciences, Providence Health Care, St. Paul’s Hospital, 575- 1081 Burrard St., Vancouver, BC V6Z 1Y6, Canada

关键词: Qualitative methods;    Opioid maintenance treatment;    Oral methadone;    Injectable;    Diacetylmorphine;    Opioid dependency;   

Others  :  1082103
DOI  :  10.1186/1940-0640-9-21

 received in 2014-04-01, accepted in 2014-09-23,  发布年份 2014

【 摘 要 】

Background

The North American Opiate Medication Initiative (NAOMI) clinical trial compared the effectiveness of injectable diacetylmorphine (DAM) or hydromorphone (HDM) to oral methadone maintenance treatment (MMT). This study aimed to determine participants’ perceptions of treatment delivered in NAOMI.

Methods

A qualitative sub-study was conducted with 29 participants (12 female): 18 (62.1%) received injectable DAM or HDM and 11 (37.9%) received MMT. A phenomenological theoretical framework was used. Semi-structured interviews were audio-recorded and transcribed verbatim. A thematic analysis was used over successive phases and was driven by the semantic meanings of the data.

Results

Participants receiving injectable medications suggested that the supervised delivery model was stringent but provided valuable stability to their lives. Females discussed the adjustment required for the clinical setting, while males focused on the challenging clinic schedule and its impact on employment abilities. Participants receiving MMT described disappointment with being randomized to this treatment; however, positive aspects, including the quick titration time and availability of auxiliary services, were also discussed.

Conclusion

Treatment with injectable DAM (or HDM) is preferred by participants and considered effective in reducing the burden of opioid dependency. Engaging patients in research regarding their perceptions of treatment provides a comprehensive assessment of treatment needs and barriers.

Clinical trial registration

NCT00175357

【 授权许可】

   
2014 Oviedo-Joekes et al.; licensee BioMed Central Ltd.

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