Table 1 Patient-Centered Care (PCC) themes
From: Patient centered medication treatment for opioid use disorder in rural Vermont: a qualitative study
PCC domain | Defining characteristics | Themes and examples | Valence | Frequency of theme |
|---|---|---|---|---|
Therapeutic Alliance | Non-judgmental, respectful and accepting | Satisfaction | ||
• Overall care satisfaction | O | Majority | ||
Empathy, understanding, warmth, kindness, supportive | • Satisfaction with care team | O | Majority | |
Trust and Support | ||||
• Felt validated | O | Majority | ||
• Staff attitudes towards use/relapse | O | Some | ||
• Team responsiveness | O | Some | ||
• Comfort with disclosure | O | Minimal | ||
Communication Quality | ||||
• Confidentiality and privacy | - | Minimal | ||
• Recognition of patient achievements | O | Minimal | ||
• Dysfunctional communication | - | Minimal | ||
• Inappropriate staff comments | - | Minimal | ||
Individualized Care | Individualized care and treatment planning | Treatment Modifications | ||
Delivery of treatment accounting to patients needs and preferences | • Appointment flexibility | O | Majority | |
• Adapted care to ongoing needs or preferences | O | Some | ||
Treatment adapted to clients’ barriers and assets | • Clinic protocols for medication access | - | Some | |
• Child-friendly clinic | O | Some | ||
Telemedicine Preferences | ||||
• Flexibility/comfort of telemedicine | + | Some | ||
• Accountability/connection of in-person interactions | + | Some | ||
Care Continuity | ||||
• Care transfer organization | O | Some | ||
• Patient factor driven discontinuation | - | Minimal | ||
Shared Decision Making | Client and provider dialogue to reach a mutual decision | Medication decisions | ||
Autonomous decision-making | • Dose changes and medication type | O | Some | |
Collaborative care | ||||
• Collaborative procedures | - | Some | ||
• Care team accountability for clinic substance testing mistakes | - | Some | ||
• Patient preference for provider-directed care | + | Minimal | ||
• Clinic abstinence expectations | - | Minimal | ||
Continuum of care decision making | ||||
• Clinic-driven discontinuation | - | Minimal | ||
• Collaborative care transfer | - | Minimal | ||
Holistic Care | Integration of physical, mental, and psychosocial support with MOUD treatment | Care team supporting non-substances needs | ||
• Biopsychosocial care coordination | + | Some | ||
• Team support above and beyond standard care | + | Minimal | ||
Gender-responsive approach to delivery of treatment | • Parental support | + | Minimal | |
Gender-responsive care | ||||
Integration of MOUD treatment as part of primary care or hospital setting for other psychosocial needs | • Dose changes related to pregnancy | O | Minimal | |
• Education about MOUD and pregnancy/sexual health | - | Minimal | ||
• Preference of counselor gender | - | Minimal | ||
Support for other substance use goals | ||||
• Support for problem alcohol use | + | Minimal | ||
• Support for problem tobacco use | + | Minimal | ||