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    Optimising treatment in opioid dependency in primary care: results from a national key stakeholder and expert focus group in Ireland.

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    12875_2018_Article_792.pdf
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    Authors
    Van Hout, Maire Claire
    Crowley, Des
    McBride, Aoife
    Delargy, Ide
    Issue Date
    2018-06-30
    Keywords
    GENERAL PRACTICE
    OPIOIDS
    Local subject classification
    ADDICTION
    
    Metadata
    Show full item record
    Is Part Of
    Substance Misuse Programme, Irish College of General Practitioners, Dublin, Ireland
    Citation
    Optimising treatment in opioid dependency in primary care: results from a national key stakeholder and expert focus group in Ireland. 2018, 19 (1):103 BMC Fam Pract
    Publisher
    BMC family practice
    Journal
    BMC family practice
    URI
    http://hdl.handle.net/10147/623112
    DOI
    10.1186/s12875-018-0792-8
    PubMed ID
    29960593
    Abstract
    Treatment for opioid dependence in Ireland is provided predominantly by general practitioners (GP) who have undergone additional training in opioid agonist treatment (OAT) and substance misuse. The National Methadone Treatment Programme (MTP) was introduced in 1998, and was designed to treat the opioid dependent population and to regulate the prescribing regimes at the time. The past two decades have seen the increased prescribing of methadone in primary care and changes in type of opioid abused, in particular, the increased use of over the counter (OTC) and prescription medications. Despite the scaling up of OAT in Ireland, drug related deaths however have increased and waiting lists for treatment exist in some areas outside the capital, Dublin. Two previous MTP reviews have made recommendations aimed at improving and scaling up of OAT in Ireland. This study updates these recommendations and is the first time that a group of national experts have engaged in structured research to identify barriers to OAT delivery in Ireland. The aim was to explore the views of national statutory and non-statutory stakeholders and experts on current barriers within the MTP and broader OAT delivery structures in order to inform their future design and implementation.
    A single focus group with a chosen group of national key stakeholders and experts with a broad range of expertise (clinical, addiction and social inclusion management, harm reduction, homelessness, specialist GPs, academics) (n = 11) was conducted. The group included national representation from the areas of drug treatment delivery, service design, policy and practice in Ireland.
    Four themes emerged from the narrative analysis, and centred on OAT Choices and Patient Characteristics; Systemic Barriers to Optimal OAT Service Provision; GP Training and Registration in the MTP, and Solutions and Models of Good Practice: Using What You Have.
    The study identified a series of improvement strategies which could reduce barriers to access and the stigma associated with OAT, optimise therapeutic choices, enhance interagency care planning within the MTP, utilise the strengths of community pharmacy and nurse prescribers, and recruit and support methadone prescribing GPs in Ireland.
    Item Type
    Article
    Language
    en
    ISSN
    1471-2296
    ae974a485f413a2113503eed53cd6c53
    10.1186/s12875-018-0792-8
    Scopus Count
    Collections
    Irish College of General Practitioners (ICGP)

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