Optimising treatment in opioid dependency in primary care: results from a national key stakeholder and expert focus group in Ireland.
Local subject classificationADDICTION
MetadataShow full item record
Is Part OfSubstance Misuse Programme, Irish College of General Practitioners, Dublin, Ireland
CitationOptimising 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
PublisherBMC family practice
JournalBMC family practice
AbstractTreatment 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.
- A national model of remote care for assessing and providing opioid agonist treatment during the COVID-19 pandemic: a report.
- Authors: Crowley D, Delargy I
- Issue date: 2020 Jul 17
- Twenty years of the methadone treatment protocol in Ireland: reflections on the role of general practice.
- Authors: Delargy I, Crowley D, Van Hout MC
- Issue date: 2019 Jan 17
- Barriers and facilitators to office-based opioid agonist therapy prescribing and effective interventions to increase provider prescribing: protocol for a systematic review.
- Authors: Nixon LL, Marlinga JC, Hayden KA, Mrklas KJ
- Issue date: 2019 Jul 25
- The Future of Opioid Agonist Therapies in Ukraine: A Qualitative Assessment of Multilevel Barriers and Ways Forward to Promote Retention in Treatment.
- Authors: Bojko MJ, Mazhnaya A, Marcus R, Makarenko I, Islam Z, Filippovych S, Dvoriak S, Altice FL
- Issue date: 2016 Jul
- Advancing pharmacological treatments for opioid use disorder (ADaPT-OUD): protocol for testing a novel strategy to improve implementation of medication-assisted treatment for veterans with opioid use disorders in low-performing facilities.
- Authors: Hagedorn H, Kenny M, Gordon AJ, Ackland PE, Noorbaloochi S, Yu W, Harris AHS
- Issue date: 2018 Dec 13