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Sharing control: user involvement in general practice based methadone maintenance

Published online by Cambridge University Press:  13 June 2014

Fiona O'Reilly ,
David O'Connell ,
Austin O'Carroll ,
David L Whitford  and
Jean Long
Fiona O'Reilly*
Affiliation:
Independent Research Consultant, Donabate, Co Dublin, Ireland
David O'Connell
Affiliation:
North City Dublin GP TrainingScheme, Eccles St, Dublin 7
Austin O'Carroll
Affiliation:
Mountjoy St Family Practice, 53 Mountjoy Street, Dublin 7
David L Whitford
Affiliation:
Medicine, RCSI-Medical University of Bahrain
Jean Long
Affiliation:
Alcohol and Drug Research Unit, Health Research Board, Third Floor, Knockmaun House, 42-47 Lower Mount Street, Dublin 2, Ireland
*
*Correspondence Email: [email protected]
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Abstract

Objectives: This study assessed patients' views of a methadone programme in a Dublin general practice including the degree to which the patients were ‘involved in decisions about their treatment’.

Method: All patients receiving methadone were asked to participate. A face to face questionnaire, with open and closed questions, was administered. Interviews lasted approximately 30 minutes. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using a thematic approach.

Results: Forty one (87%) of the 47 patients attending the general practice methadone service were interviewed. Of the 39 patients who had used heroin on admission, 69% had stopped and 31% reduced heroin use since starting methadone treatment. A total of 71% reported that the doctor either always involved (59%) or sometimes involved (12%) them in decisions about their treatment. Involvement was interpreted as ‘being listened to’ or ‘having a say’ in deciding methadone dose. Surprisingly those who reported that they were not involved in treatment decisions were more likely to have stopped heroin use (10/11). A significant majority of patients (81%) expressed the desire to stop taking methadone.

Conclusion: Most patients receiving methadone in general practice were listened to and had a say in deciding their methadone dose but did not have an opportunity to engage in more structured or contractual forms of involvement in treatment such as written care plans. In line with a patient centred approach, treatment providers should set their sights beyond the safe delivery of methadone, to provide a service which is centred on patient goals, expectations and choice.

Keywords

Consumer participationMethadonePrimary health careGeneral Practice
Type
Original papers
Information
Irish Journal of Psychological Medicine , Volume 28 , Issue 3 , September 2011 , pp. 129 - 133
Copyright
Copyright © Cambridge University Press 2011

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