Healthcare seeking among Swedish patients in opioid substitution treatment – a mixed methods study on barriers and facilitators

Substance Abuse Treatment, Prevention, and Policy

Karin Lundqvist¹  Disa Dahlman²  Katja Troberg³  Anders Håkansson³  Helena Hansson⁴ 

[1]Center for Primary Health Care Research, Department of Clinical Sciences, Lund University/Region Skåne, Malmö, Sweden

[2]Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden

[3]Center for Primary Health Care Research, Department of Clinical Sciences, Lund University/Region Skåne, Malmö, Sweden

[4]Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden

[5]Malmö Addiction Centre, Skåne University Hospital, Malmö, Sweden

[6]School of Social Work, Faculty of Social Sciences, Lund University, Lund, Sweden

关键词: Opioid substitution treatment;    Healthcare seeking;    Unmet healthcare needs;    Barriers and facilitators;    Stigma;   

DOI  :  10.1186/s13011-022-00434-w

来源: Springer

【 摘 要 】

BackgroundPatients in opioid substitution treatment (OST) have poorer health than the general population. Thus, they do not seek somatic health care to the extent that is medically motivated. Barriers hindering patients from seeking medical help through the conventional healthcare system result in a high degree of unmet healthcare needs. Barriers to, and facilitators of, OST patients’ healthcare seeking have been sparsely examined.MethodsMixed methods were employed. The quantitative part consisted of a cross-sectional questionnaire covering questions on physical health, healthcare seeking, and barriers thereof, which was collected from 209 patients in OST. A sub-sample of eleven OST patients participated in semi-structured interviews, for the qualitative part of the study, covering experience of healthcare, lifestyle, and self-images, expectations, and ideals of Swedish healthcare.ResultsConfirmed by qualitative data, quantitative data revealed deprioritization, fear of stigma and of being treated badly, and problems in navigation throughout the healthcare system, leading to unsuccessful establishment of contact, being most common reasons for not seeking somatic healthcare. Thus, interviewees provided a deeper knowledge of the barriers stigma, lack of means to prioritize health and difficulties navigating throughout the healthcare system, leading to resignation and deprioritization. On-site primary healthcare (PHC) seemed to contribute to increased access and utilization of healthcare.ConclusionIndividual and structural barriers decreasing access to healthcare lead to increased inequalities in healthcare utilization, adding to an already deteriorating health of this ageing population. Integration of on-site primary healthcare and OST could provide acceptable and accessible healthcare.

【 授权许可】

CC BY