Understanding Engagement in Care for Patients Who Access Opioid Agonist Therapy

Context: In 2022, northern British Columbia (BC) had the highest rate of illicit drug toxicity deaths in that province.

Objective: To understand patient acceptability of local services providing opioid agonist therapy (OAT).

Study Design and Analysis: Patient-oriented research led to co-design of an interview guide that used the Candidacy framework to identify people’s motivations, fears, and ability to navigate OAT services. Findings were analyzed interpretively within the Candidacy framework and included the patient partner in analysis. The findings from the interview study were used to design a prioritization exercise to help identify actionable changes to support patient engagement with health care settings providing OAT services.

Setting: a small city that also serves as the regional centre for health services in northern BC.

Population Studied: Adults currently prescribed OAT or had been prescribed OAT within the past 12 months.

Intervention: N/a.

Outcome Measures: N/a.

Results: Participants valued being asked about their goals and preferences, and reported that when a provider understands a person’s motivations for seeking OAT, it can reinforce engagement in care. Participants were clear that abstinence messaging is alienating. Participants also reported that navigating services and appointments required to engage in OAT can be destabilizing. Practices that providers can undertake to promote engagement in care were identified, as were messages for decision makers about types of OAT services that are patient-centred.

Conclusions: The unregulated drug poisoning emergency in BC is in its seventh year and promoting engagement in OAT continues to be a priority. Patients can help identify the types of services and provider practices that support engagement in care.