Conceptualizing patient-centered care for substance use disorder treatment: findings from a systematic scoping review

Substance Abuse Treatment, Prevention, and Policy

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[1] 0000 0000 8658 0974, grid.436533.4, Northern Ontario School of Medicine, 935 Ramsey Lake Road, P3E 2C6, Sudbury, ON, Canada;0000 0001 2288 9830, grid.17091.3e, School of Population and Public Health, University of British Columbia, 2206 East Mall, V6T 1Z3, Vancouver, BC, Canada;0000 0000 8589 2327, grid.416553.0, Centre for Health Evaluation & Outcome Sciences, Providence Health Care, St. Paul’s Hospital, 575- 1081 Burrard St, V6Z 1Y6, Vancouver, BC, Canada;0000 0004 0633 9101, grid.415289.3, Providence Health Care, Providence Crosstown Clinic, 84 West Hastings St, V6B 1G6, Vancouver, BC, Canada;Canadian Association for Safe Supply, 46 East Hastings St, V6A 1N1, Vancouver, BC, Canada;

关键词: Patient-centered care;    Client-centered care;    Substance-related disorders;    Scoping review;    Directed content analysis;   

DOI  :  10.1186/s13011-019-0227-0

来源: publisher

【 摘 要 】

BackgroundDespite ongoing efforts aimed to improve treatment engagement for people with substance-related disorders, evidence shows modest rates of utilization as well as client-perceived barriers to care. Patient-centered care (PCC) is one widely recognized approach that has been recommended as an evidence-based practice to improve the quality of substance use disorder treatment. PCC includes four core principles: a holistic and individualized focus to care, shared decision-making and enhanced therapeutic alliance.AimsThis scoping review aimed to explore which PCC principles have been described and how they have defined and measured among people with substance-related disorders.MethodsFollowing the iterative stages of the Arksey and O’Malley scoping review methodology, empirical (from Medline, Embase, PsycINFO, CINAHL and ISI Web of Science) and grey literature references were eligible if they focused on people accessing treatment for substance-related disorders and described PCC. Two reviewers independently screened the title/abstract and full-texts of references. Descriptive analyses and a directed content analysis were performed on extracted data.FindingsOne-hundred and forty-nine references met inclusion from the 2951 de-duplicated references screened. Therapeutic alliance was the most frequent principle of PCC described by references (72%); this was consistently defined by characteristics of empathy and non-judgment. Shared decision-making was identified in 36% of references and was primarily defined by client and provider strategies of negotiation in the treatment planning process. Individualized care was described by 30% of references and included individualized assessment and treatment delivery efforts. Holistic care was identified in 23% of references; it included an integrated delivery of substance use, health and psychosocial services via comprehensive care settings or coordination. Substance use and treatment engagement outcomes were most frequently described, regardless of PCC principle.ConclusionsThis review represents a necessary first step to explore how PCC has been defined and measured for people accessing substance use disorder treatment. The directed content analysis revealed population and context-specific evidence regarding the defining characteristics of PCC-principles that can be used to further support the implementation of PCC.

【 授权许可】

CC BY