Healthcare staff's perspectives on long-acting injectable buprenorphine treatment: a qualitative interview study

• Published in: Addiction science & clinical practice Vol. 19; no. 1; pp. 25 - 11
• Main Authors: Nordgren, Johan, Monwell, Bodil, Johnson, Björn, Gunnarsson, Nina Veetnisha, Capusan, Andrea Johansson
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 05-04-2024; BioMed Central; BMC
• Subjects: Alliances; Analysis; Buprenorphine; Care and treatment; Clinical Medicine; Clinics; Data analysis; Drug dosages; Drug use; Drugs; Focus groups; Interviews; Klinisk medicin; Medical and Health Sciences; Medicin och hälsovetenskap; Narcotics; Nurses; Opioids; Patient compliance; Patient satisfaction; Physicians; Psychiatry; Psykiatri; Qualitative research; Samhällsvetenskap; Social Sciences; Social Work; Socialt arbete; Sociologi; Sociology; Substance abuse; Visits; Sweden
• ISSN: 1940-0640; 1940-0632; 1940-0640
• DOI: 10.1186/s13722-024-00458-6

Long-acting injectable buprenorphine (LAIB) formulations are a novel treatment approach in opioid agonist treatment (OAT), which provide patients with a steady dose administered weekly or monthly and thus reduce the need for frequent clinic visits. Several studies have analyzed patient experiences of LAIB but the perspective of OAT staff is unknown. This study aimed to explore how healthcare staff working in OAT clinics in Sweden perceive and manage treatment with LAIB.
Individual qualitative interviews were conducted with OAT physicians (n = 10) in tandem with nine focus group sessions with OAT nurses and other staff categories (n = 41). The data was analyzed with thematic text analysis.
Five central themes were identified in the data: (1) advantages and disadvantages of LAIB, (2) patient categories that may or may not need LAIB, (3) patients' degrees of medication choice, (4) keeping tabs, control and treatment alliance, and (5) LAIB's impact on risk and enabling environments in OAT. Overall staff found more advantages than disadvantages with LAIB and considered that patients with ongoing substance use and low adherence were most likely to benefit from LAIB. However, less frequent visits were viewed as problematic in terms of developing a treatment alliance and being able to keep tabs on patients' clinical status. Clinics differed regarding patients' degrees of choice in medication, which varied from limited to extensive. LAIB affected both risk and enabling environments in OAT.
LAIB may strengthen the enabling environment in OAT for some patients by reducing clinic visits, exposure to risk environments, and the pressure to divert medication. A continued discussion about the prerequisites and rationale for LAIB implementation is needed in policy and practice.