PRP125: Models of care for treatment of Opioid Use disorder with Buprenorphine/Naloxone in primary care : A Study Protocol

Andree-Anne Pare-Plante, MD, MSc, CCFP (AM)


Context: With access to treatment for opioid use disorder (OUD) being a main issue in the Opioid Crisis, primary care practices are encouraged in Quebec to initiate patients with Buprenorphine/Naloxone therapy rather than Methadone. Buprenorphine/Naloxone is preferred because of its ease of use, its secure profile of adverse effects and the rapid comfort it brings to patients. However, the treatment with this medication has mostly been prescribed in a specialized care setting in North America.
Objective: Describe one or many models of care with Buprenorphine/Naloxone treatment for OUD in primary care.
Design: Multiple case series with multiple sources of data: semi-structured individual interviews, logbook, treatment protocol reviews, focus groups and direct observations.
Setting: Five primary care organizations in the greater Montreal area, Quebec, Canada. The participating clinics already all offer buprenorphine/naloxone treatment for OUD patients.
Participants: 6-8 patients from each clinic will be recruited. Physicians, nurses and clinical managers and other types of professionals from each clinic will be recruited to represent the variety of healthcare workers of primary care.
Outcomes: Barriers and facilitators to the treatment with Buprenorphine/Naloxone in primary care. Patients’ experiences with the treatment, the primary care organization and their healthcare providers. Expectations and needs by patients, healthcare workers and managers to improve the implementation of Buprenorphine/Naloxone treatment in primary care.
Results: Anticipated results on the outcomes will bring shareable knowledge of winning strategies of care between the clinics. It will allow the co-creation of a guide to the treatment of OUD with Buprenorphine/Naloxone in primary care with the participants and the organizations involved in the study.
Conclusion: The qualitative nature of this study will bring in depth comprehension of Buprenorphine/Naloxone treatment for OUD in a primary care setting, whereas before most studies have been done in specialized addiction treatment centers.

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