Patient Satisfaction With Standard Methadone and Flexible Buprenorphine/Naloxone Models of Care: Results From a Pragmatic Randomized Controlled Clinical Trial : Journal of Addiction Medicine

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Original Research

Patient Satisfaction With Standard Methadone and Flexible Buprenorphine/Naloxone Models of Care: Results From a Pragmatic Randomized Controlled Clinical Trial

Hassan, Ahmed N. MD, FRCPC, MPH; Bozinoff, Nikki MD, MSc, CCFP; Jutras-Aswad, Didier MD, MSc, FRCPC; Socias, M. Eugenia MD, MSc; Stewart, Sherry H. PhD; Lim, Ron MD, CCFP, DFASAM; Le Foll, Bernard MD, PhD, MCFP;  The OPTIMA Research Group

Author Information
Journal of Addiction Medicine 17(1):p e49-e56, 1/2 2023. | DOI: 10.1097/ADM.0000000000001048

Abstract

Introduction 

Patient satisfaction is a critical measure of quality of care across health disciplines because it may affect clinical outcomes.

Objectives 

This study aimed to examine longitudinal patient satisfaction in individuals with opioid use disorder (OUD) randomized to receive either standard methadone or flexible buprenorphine/naloxone models of care, its predictors, and association with dropout/illicit drug use.

Methods 

This study assessed patient satisfaction, using the 8-item version of the Client Satisfaction Questionnaire (CSQ), as a secondary outcome of a large phase IV pragmatic randomized controlled trial (OPTIMA). The effectiveness of standard methadone model of care was compared with flexible take-home buprenorphine/naloxone dispensation model of care in patients with prescription-type OUD. Of 272 participants recruited and followed up for 24 weeks, 183 were eligible for this study.

Results 

Throughout the study, patients were “satisfied” with their treatment. The average CSQ score was not significantly different between weeks 4, 12, and 24 in the total sample (χ2 = 0.35; P = 0.84). There was no significant difference in CSQ based on treatment assignment (methadone vs flexible buprenorphine/naloxone) either overall (z = 0.87; P = 0.38) or over time (χ2 = 0.65; P = 0.72). High levels of depression at baseline and decreased depressive symptoms over the follow-up period predicted positive changes in patient satisfaction (P = 0.03 and P = <0.01, respectively). Satisfaction was significantly associated with treatment retention but not illicit drug use.

Conclusions 

This study demonstrates that patients with OUD on either standard methadone or flexible buprenorphine were generally satisfied with their treatment, with no difference in patient satisfaction based on treatment allocation. Given the ongoing opioid crisis, strategies to improve patient satisfaction should be further explored.

Copyright © 2022 American Society of Addiction Medicine

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