Determining Patient-Defined Treatment Outcomes in Opioid Use Disorder

Overview

In the last decade Tennessee has seen a continual rise in total deaths due to opioid overdose with a rate in 2017 of 19.3 deaths per 100,000 persons, above the national average. (1) Medication-assisted treatment (MAT) is an effective treatment for opioid use disorder (OUD). Although other options are available, methadone-based MAT has been a mainstay for many patients given its cost, structured dosing, and effectiveness.(2-4) Despite barriers to MAT, about 50-60% of patients remain in treatment, yet their personal goals and motivations for doing so remain largely unknown and likely differ from those of their providers.(5-8) This is important because MAT providers are not currently trained about patient-defined treatment goals or how to incorporate them within a care plan. As a consequence, treatment plans emphasize goals important to the provider and other stakeholders, but not the patient, and this may result in lower rates of retention. The objective of this study is to identify the motivations and patient-defined treatment goals of OUD patients enrolled in methadone-based MAT across the three regions of Tennessee. A secondary objective will be the development of a theoretical framework from these results for use by educational content developers. Our long-term goal is to develop a patient-centered MAT training program in collaboration with the Tennessee Department of Mental Health and substance Abuse Services (TDMHSAS). Aim 1: To report patient-defined treatment goals and motivations of adult patients with substance use disorder undergoing MAT with methadone in Tennessee. Aim 2: To determine barriers and facilitators of patients’ adherence to MAT regimens. Aim 3: To develop a theoretical framework that will inform the development of a novel statewide training program to aid MAT providers and counselors in providing care.