• Elizabeth J Austin, Jessica Chen, Elena Soyer, Bulat Idrisov, Elsa S Briggs, Lori Ferro, Andrew J Saxon, John C Fortney, Geoffrey M Curran, Yavar Moghimi, Brittany E Blanchard, Emily C Williams, Anna D Ratzliff, Monica S Ruiz, and Ulrich Koch.
• Department of Health Systems and Population Health, School of Public Health, University of Washington, Box 351621, Seattle, WA, USA. austie@uw.edu.
• J Gen Intern Med. 2024 Jul 29.

BackgroundOpioid use disorder (OUD) care engagement rates in primary care (PC) settings are often low. Little is known about PC team experiences when delivering OUD treatment and potential factors that influence their capacity to engage patients in treatment. Exploring PC team experiences may inform needed supports that can optimize OUD care delivery and improve outcomes for patients with OUD.ObjectiveWe explored multidisciplinary PC team perspectives on barriers and facilitators to engaging patients in OUD treatment.DesignQualitative study using in-depth interviews.ParticipantsPrimary care clinical teams.ApproachWe conducted semi-structured interviews (n = 35) with PC team members involved in OUD care delivery, recruited using a combination of criterion and maximal variation sampling. Data collection and analysis were informed by existing theoretical literature about patient engagement, specifically that patient engagement is influenced by factors across individual (patient, provider), interpersonal (patient-provider), and health system domains. Interviews were professionally transcribed and doubled-coded using a coding schema based on the interview guide while allowing for emergent codes. Coding was iteratively reviewed using a constant comparison approach to identify themes and verified with participants and the full study team.Key ResultsAnalysis identified five themes that impact PC team ability to engage patients effectively, including limited patient contact (e.g., phone, text) in between visits, varying levels of provider confidence to navigate OUD treatment discussions, structural factors (e.g., schedules, productivity goals) that limited provider time, the role of team-based approaches in lessening discouragement and feelings of burnout, and lack of shared organizational vision for reducing harms from OUD.ConclusionsWhile the capacity of PC teams to engage patients in OUD care is influenced across multiple levels, some of the most promising opportunities may involve addressing system-level factors that limit PC team time and collaboration and promoting organizational alignment on goals for OUD treatment.© 2024. The Author(s), under exclusive licence to Society of General Internal Medicine.

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