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A mixed‐methods analysis of patient safety incidents involving opioid substitution treatment with methadone or buprenorphine in community‐based care in England and Wales.

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Title: A mixed‐methods analysis of patient safety incidents involving opioid substitution treatment with methadone or buprenorphine in community‐based care in England and Wales.
Authors: Gibson, Russell (AUTHOR), MacLeod, Natalie (AUTHOR), Donaldson, Liam J. (AUTHOR), Williams, Huw (AUTHOR), Hibbert, Peter (AUTHOR), Parry, Gareth (AUTHOR), Bhatt, Jay (AUTHOR), Sheikh, Aziz (AUTHOR), Carson‐Stevens, Andrew (AUTHOR)
Source: Addiction. Nov2020, Vol. 115 Issue 11, p2066-2076. 11p. 2 Diagrams, 4 Charts.
Subjects: Methadone treatment programs, Therapeutic use of narcotics, Analgesics, Buprenorphine, Communication, Community health services, Drugs, Drug prescribing, Research methodology, Medical care, Patient compliance, Patient safety, Primary health care, Substance abuse, Physician practice patterns, Thematic analysis, Descriptive statistics
Geographic Terms: Wales, England
Abstract: Background and Aims: Opioid substitution treatment is used in many countries as an effective harm minimization strategy. There is a need for more information about patient safety incidents and the resulting harm relating to this treatment. We aimed to characterize patient safety incidents involving opioid substitution treatment with methadone or buprenorphine in community‐based care by: (i) identifying the sources and nature of harm and (ii) describing and interpreting themes to identify priorities to focus future improvement work. Design Mixed‐methods study examining patient safety incident reports involving opioid substitution treatment with either methadone or buprenorphine in community‐based care. Setting: Data submitted between 2005 and 2015 from the National Reporting and Learning System (NRLS), a national repository of patient safety incident reports from across England and Wales. Participants: A total of 2284 reports were identified involving patients receiving community‐based opioid substitution treatment. Measurements Incident type, contributory factors, incident outcome and severity of harm. Analysis involved data coding, processing and iterative generation of data summaries using descriptive statistical and thematic analysis. Findings Most risks of harm from opioid substitution treatment came from failure in one of four processes of care delivery: prescribing opioid substitution (n = 151); supervised dispensing (n = 248); non‐supervised dispensing (n = 318); and monitoring and communication (n = 1544). Most incidents resulting in harm involved supervised or non‐supervised dispensing (n = 91 of 127, 72%). Staff‐ (e.g. slips during task execution, not following protocols) and organization‐related (e.g. poor working conditions or poor continuity of care between services) contributory factors were identified for more than half of incidents. Conclusions: Risks of harm in delivering opioid substitute treatment in England and Wales appear to arise out of failures in four processes: prescribing opioid substitution, supervised dispensing, non‐supervised dispensing and monitoring and communication. [ABSTRACT FROM AUTHOR]
Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: A mixed‐methods analysis of patient safety incidents involving opioid substitution treatment with methadone or buprenorphine in community‐based care in England and Wales.
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  Data: <searchLink fieldCode="JN" term="%22Addiction%22">Addiction</searchLink>. Nov2020, Vol. 115 Issue 11, p2066-2076. 11p. 2 Diagrams, 4 Charts.
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  Data: Background and Aims: Opioid substitution treatment is used in many countries as an effective harm minimization strategy. There is a need for more information about patient safety incidents and the resulting harm relating to this treatment. We aimed to characterize patient safety incidents involving opioid substitution treatment with methadone or buprenorphine in community‐based care by: (i) identifying the sources and nature of harm and (ii) describing and interpreting themes to identify priorities to focus future improvement work. Design Mixed‐methods study examining patient safety incident reports involving opioid substitution treatment with either methadone or buprenorphine in community‐based care. Setting: Data submitted between 2005 and 2015 from the National Reporting and Learning System (NRLS), a national repository of patient safety incident reports from across England and Wales. Participants: A total of 2284 reports were identified involving patients receiving community‐based opioid substitution treatment. Measurements Incident type, contributory factors, incident outcome and severity of harm. Analysis involved data coding, processing and iterative generation of data summaries using descriptive statistical and thematic analysis. Findings Most risks of harm from opioid substitution treatment came from failure in one of four processes of care delivery: prescribing opioid substitution (n = 151); supervised dispensing (n = 248); non‐supervised dispensing (n = 318); and monitoring and communication (n = 1544). Most incidents resulting in harm involved supervised or non‐supervised dispensing (n = 91 of 127, 72%). Staff‐ (e.g. slips during task execution, not following protocols) and organization‐related (e.g. poor working conditions or poor continuity of care between services) contributory factors were identified for more than half of incidents. Conclusions: Risks of harm in delivering opioid substitute treatment in England and Wales appear to arise out of failures in four processes: prescribing opioid substitution, supervised dispensing, non‐supervised dispensing and monitoring and communication. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=146320045
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        Value: 10.1111/add.15039
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        Text: English
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      – SubjectFull: Methadone treatment programs
        Type: general
      – SubjectFull: Therapeutic use of narcotics
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      – SubjectFull: Analgesics
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      – SubjectFull: Buprenorphine
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      – SubjectFull: Drugs
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      – SubjectFull: Research methodology
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      – SubjectFull: Medical care
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      – SubjectFull: Patient safety
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Wales
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      – SubjectFull: England
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