Barriers and Facilitators of Managing Opioid Use Disorder in Primary Care and the Potential of Using a Software-based Measurement-Based Care Program: A Qualitative Study

Abstract

Background: Opioid use disorder (OUD) is a deadly disease that remains undertreated, despite effective pharmacological treatments. Barriers, such as stigma and affordability, and a lack of training and prescribing within medical practices result in low access to treatment. Software-delivered measurement-based care (MBC) is one way to increase treatment access. MBC uses systematic participant symptom assessments to inform an algorithm to provide support for physicians at critical decision points. Method: A qualitative study using focus groups of faculty clinicians (N = 33) from 3 clinics were conducted to understand perceptions of OUD diagnosis and treatment and whether a computerized MBC model might assist with diagnosis and treatment. Themes from the transcribed focus groups were identified in two phases: 1) content analysis focused on uncovering general themes; and 2) systematic coding and interpretation of the data. Results: Analysis revealed six major themes utilized to develop the coding terms: “perceptions of opioid use,” “current practices with patients using prescribed or illicit opioids or other drugs,” “attitudes and feelings about providing screening or treatment for OUD in your practice,” “perceived resources needed for treating OUD,” “primary care physician role in patient care not specific to OUD,” and “reactions to implementation of proposed clinical decision support tool.” Conclusion: Results revealed systemic and attitudinal barriers for screening, diagnosing, and treating OUD that could be alleviated with the implementation of a software-based MBC program. Providers tended to view the software-based MBC program favorably, indicating that it may be a solution to increasing accessibility to OUD treatment.