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Abstract

Objective:

Substance use disorder treatment professionals are paying increased attention to implementing patient-centered care. Understanding environmental and organizational factors associated with clinicians’ efforts to engage patients in clinical decision-making processes is essential for bringing patient-centered care to the addictions field. This study examined factors associated with patient-centered care practices in substance use disorder treatment.

Methods:

Data were from the 2017 National Drug Abuse Treatment System Survey, a nationally representative survey of U.S substance use disorder treatment clinics (outpatient nonopioid treatment programs, outpatient opioid treatment programs, inpatient clinics, and residential clinics). Multivariate regression analyses examined whether clinics invited patients into clinical decision-making processes and whether clinical supervisors supported and believed in patient-centered care practices.

Results:

Of the 657 substance use disorder clinics included in the analysis, about 23% invited patients to participate in clinical decision-making processes. Clinicians were more likely to engage patients in decision-making processes when working in residential clinics (compared with outpatient nonopioid treatment programs) or in clinics serving a smaller proportion of patients with alcohol or opioid use disorder. Clinical supervisors were more likely to value patient-centered care practices if the organization’s administrative director perceived less regional competition or relied on professional information sources to understand developments in the substance use disorder treatment field. Clinicians’ tendency to engage patients in decision-making processes was positively associated with clinical supervisors’ emphasis on patient-centered care.

Conclusions:

A minority of U.S. substance use disorder clinics invited patients into clinical decision-making processes. Therefore, patient-centered care may be unavailable to certain vulnerable patient groups.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 35 - 42
PubMed: 31500544

History

Received: 4 March 2019
Revision received: 6 June 2019
Accepted: 26 July 2019
Published online: 10 September 2019
Published in print: January 01, 2020

Keywords

  1. Administration and management
  2. Staff relationships/roles
  3. Patient-centered care
  4. Coproduction
  5. Clinician-patient engagement
  6. Organizational study

Authors

Details

Sunggeun (Ethan) Park, Ph.D. [email protected]
School of Social Work, University of Michigan, Ann Arbor (Park); School of Social Service Administration, University of Chicago, Chicago (Grogan, Mosley, Pollack); Health Services Research & Development, U.S. Department of Veterans Affairs Medical Center, Palo Alto, California, and Department of Psychiatry, Stanford University Medical Center, Stanford, California (Humphreys); Department of Medicine, University of Massachusetts­–Baystate, and Office of Research, Baystate Health, Springfield, Massachusetts (Friedmann).
Colleen M. Grogan, Ph.D.
School of Social Work, University of Michigan, Ann Arbor (Park); School of Social Service Administration, University of Chicago, Chicago (Grogan, Mosley, Pollack); Health Services Research & Development, U.S. Department of Veterans Affairs Medical Center, Palo Alto, California, and Department of Psychiatry, Stanford University Medical Center, Stanford, California (Humphreys); Department of Medicine, University of Massachusetts­–Baystate, and Office of Research, Baystate Health, Springfield, Massachusetts (Friedmann).
Jennifer E. Mosley, Ph.D.
School of Social Work, University of Michigan, Ann Arbor (Park); School of Social Service Administration, University of Chicago, Chicago (Grogan, Mosley, Pollack); Health Services Research & Development, U.S. Department of Veterans Affairs Medical Center, Palo Alto, California, and Department of Psychiatry, Stanford University Medical Center, Stanford, California (Humphreys); Department of Medicine, University of Massachusetts­–Baystate, and Office of Research, Baystate Health, Springfield, Massachusetts (Friedmann).
Keith Humphreys, Ph.D.
School of Social Work, University of Michigan, Ann Arbor (Park); School of Social Service Administration, University of Chicago, Chicago (Grogan, Mosley, Pollack); Health Services Research & Development, U.S. Department of Veterans Affairs Medical Center, Palo Alto, California, and Department of Psychiatry, Stanford University Medical Center, Stanford, California (Humphreys); Department of Medicine, University of Massachusetts­–Baystate, and Office of Research, Baystate Health, Springfield, Massachusetts (Friedmann).
Harold A. Pollack, Ph.D.
School of Social Work, University of Michigan, Ann Arbor (Park); School of Social Service Administration, University of Chicago, Chicago (Grogan, Mosley, Pollack); Health Services Research & Development, U.S. Department of Veterans Affairs Medical Center, Palo Alto, California, and Department of Psychiatry, Stanford University Medical Center, Stanford, California (Humphreys); Department of Medicine, University of Massachusetts­–Baystate, and Office of Research, Baystate Health, Springfield, Massachusetts (Friedmann).
Peter D. Friedmann, M.D., M.P.H.
School of Social Work, University of Michigan, Ann Arbor (Park); School of Social Service Administration, University of Chicago, Chicago (Grogan, Mosley, Pollack); Health Services Research & Development, U.S. Department of Veterans Affairs Medical Center, Palo Alto, California, and Department of Psychiatry, Stanford University Medical Center, Stanford, California (Humphreys); Department of Medicine, University of Massachusetts­–Baystate, and Office of Research, Baystate Health, Springfield, Massachusetts (Friedmann).

Notes

Send correspondence to Dr. Park ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

National Institute on Drug Abusehttp://dx.doi.org/10.13039/100000026: 5R01DA024549
This work was supported by grant 5R01DA024549 from the National Institute on Drug Abuse (NIDA).

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