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Patient-centered care's relationship with substance use disorder treatment utilization.

Park SE, Mosley JE, Grogan CM, Pollack HA, Humphreys K, D'Aunno T, Friedmann PD. Patient-centered care's relationship with substance use disorder treatment utilization. Journal of substance abuse treatment. 2020 Nov 1; 118:108125.

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BACKGROUND: Calls for more patient-centered care are growing in the substance use disorder (SUD) treatment field. However, evidence is sparse regarding whether patient-centered care improves access to, or utilization of, effective treatment services. METHODS: Using nationally representative survey data from SUD treatment clinics in the United States, we examine the association between patient-centered clinical care and the utilization of six services: methadone, buprenorphine, behavioral treatment, routine medical care, HIV testing, and suicide prevention counseling. We measured clinics'' practice of and emphasis on patient-centered care with two variables: (1) whether the clinic regularly invites patients into clinical decision-making processes, and (2) whether supervisors believe in patient-centered healthcare and shared decision-making practices within their clinics. RESULTS: In 2017, only 23% of SUD treatment clinics regularly invited patients into care decision-making meetings when their cases were discussed. A composite variable captured clinical supervisors'' own experience with and expectations for patient-clinician interaction within their clinics (Cronbach''s alpha  =  0.79). Results from regression models that controlled for several organizational and environmental factors show that patient-centered care was independently associated with greater utilization of four of six evidence-based services. CONCLUSIONS: A minority of SUD clinics practice patient-centered healthcare in the United States. Given the connection to evidence-based services, increasing participatory mechanisms in SUD treatment service provision can facilitate patients'' access to appropriate and evidence-based services.

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