“It’s Gonna be a Lifeline”: Findings From Focus Group Research to Investigate What People Who Use Opioids Want From Peer-Based Postoverdose Interventions in the Emergency Department - 20/11/20
, Maria L. Mittal, MD b, Robert W. Harding, BA a, Krysti P. Smith, MPM a, Ashley D. Dawkins, BS a, Xing Wei, MPH a, Stephanie Woodard, PsyD c, Nancy A. Roget, MS d, Roy F. Oman, PhD aAbstract |
Study objective |
Postoverdose interventions that deploy peer recovery support specialists to emergency departments (EDs) are a promising response to opioid overdoses among patients presenting in EDs. The objective of this study was to elicit patients’ perspectives regarding the feasibility and acceptability of such an intervention and to ensure that their perspectives are represented in intervention design, implementation, and evaluation.
Method |
In 2019 the study investigators conducted focus groups with people who use opioids to elicit perspectives about a postoverdose intervention delivered in the ED by using a semistructured interview guide that asked about feasibility, acceptability, perceived benefits, and concerns. Focus groups were digitally recorded, transcribed, and analyzed for emerging themes.
Results |
Nine focus groups with 30 people who use opioids were conducted. Key findings that could improve feasibility and acceptability of the intervention include the following: the importance of balancing the urgency of seeing patients quickly with a need to accommodate the experience of precipitated withdrawal symptoms; the need to address privacy concerns; and the need to address concerns related to cost, insurance coverage, and sustainability. Perceived benefits of the intervention included the ability of the peer recovery support specialist to provide advocacy and support, serve as a model of hope and encouragement for behavior change, and fill key service gaps.
Conclusion |
Postoverdose interventions in the ED provide the opportunity to integrate harm reduction–based interventions into traditional biomedical care facilities. These interventions can fill gaps in services and provide additional care and comfort for people who use opioids, but design, implementation, and evaluation should be informed by a patient-centered care perspective.
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| Please see page 718 for the Editor’s Capsule Summary of this article. |
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| Supervising editor: Kristin L. Rising, MD, MS. Specific detailed information about possible conflict of interest for individual editors is available at editors. |
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| Author contributions: KDW conceived of the study and served as principal investigator and lead analyst. MLM contributed to the qualitative analysis and interpretation and reporting of findings. RWH, KPS, and ADD conducted the data collection and contributed to interpretation and reporting of findings. XW conducted the quantitative analysis. SW, NAR, and RFO contributed to the overall conceptualization of the research, acquisition of funding, and interpretation and reporting of findings. KDW takes responsibility for the paper as a whole. |
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| All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. |
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist. This research was supported by a grant from Arnold Ventures. The views in this paper do not necessarily represent the views of the funders. KDW, KPS, RWH, and NAR have received funding to assist with the implementation of the Substance Abuse and Mental Health Services Administration Opioid State Targeted Response grant, which funded the intervention activities described in this report. MLM is supported by National Institute of Drug Abuse grant 3R01DA040648-02S1. SW is the state administrator responsible for the overall implementation of the intervention activities described in this report. |
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Vol 76 - N° 6
P. 717-727 - décembre 2020 Retour au numéro
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