Aug 2026· Journal of Umm Al-Qura University for Medical Science· Vol 12· 0 citations· 36 references
TL;DR
Healthcare providers’ (HCPs) perspectives on factors shaping patient management and treatment acceptance in specialized SUD centers in Baghdad are explored, utilizing the Systems Engineering Initiative for Patient Safety (SEIPS) model.
Abstract
Substance Use Disorder (SUD) is a chronic, relapsing condition that poses a significant public health challenge in Iraq. Evaluating the work system within specialized centers is essential for identifying barriers to effective patient management. This study aimed to explore healthcare providers’ (HCPs) perspectives on factors shaping patient management and treatment acceptance in specialized SUD centers in Baghdad, utilizing the Systems Engineering Initiative for Patient Safety (SEIPS) model. A qualitative study was conducted between December 2023 and July 2024 at two specialized facilities: a social rehabilitation center (Site A) and an addiction treatment hospital (Site B). Semi-structured face-to-face interviews were held with 28 HCPs, including psychiatrists and nurses. Data were analyzed using Braun and Clarke’s thematic analysis framework and organized according to the five SEIPS domains: person, tasks, tools/technology, organization, and environment. Key findings across the SEIPS domains revealed significant systemic barriers. In the Person domain, HCPs highlighted inadequate specialized training and weak patient willpower fueled by the availability of substances. Tasks were characterized by the high effort required for continuous counseling and managing aggressive behavior. In the Tools and Organization domains, severe shortages of specialized staff, lack of electronic health records, and inadequate assessment spaces were reported. Environmentally, overcrowding and the “prison-like” atmosphere of facilities negatively impacted patient motivation. Effective SUD management in Iraq is hindered by structural limitations, workforce shortages, and environmental stressors. Enhancing treatment outcomes requires a multidisciplinary approach, including specialized staff training, infrastructure modernization, and stronger inter-ministerial collaboration to address post-discharge relapse triggers.
Key challenges identified included the absence of integrated treatment for comorbid mental health conditions, frequent relapses, lack of culturally adaptive interventions, limited innovation in treatment approaches, minimal family involvement, and absence of individualized treatment planning.
F. Ahmed, Djamil A Malik· Foundation University Journa...· 0 citations
Abstract Objectives Substance use disorder (SUD) care continues to be hindered by persistent gaps in health information exchange (HIE). This study examined people, organizational, regulatory, and technical barriers to SUD data sharing from the provider perspective and identified key opportunities to improve care through health record interoperability. Materials and Methods Behavioral health providers (52% prescribers) representing 4 SUD treatment organizations in 14 US states participated in 11 focus groups (n = 31) and 5 validation interviews (n = 5) covering scenarios related to SUD Healthcare Effectiveness Data and Information Set (HEDIS) metrics. Thematic analysis, keyword searches, and workflow analysis [using Unified Modeling Language (UML) diagrams] were performed. Results Incomplete data access at the point of care frequently necessitated manual exchange via fax, phone, and secure email. When available, HIE and Prescription Drug Monitoring Program (PDMP) data were helpful, but confusion regarding the release of SUD information requirements in the context of HIPAA (Health Insurance Portability and Accountability Act), 42 CFR (Code of Federal Regulations) Part 2 and state requirements was ubiquitous. UML modeling of 4 core SUD care scenarios rising from participants’ HEDIS examples revealed 3 common data sharing subprocesses. Discussion Fragmented data sharing workflows, and extensive use of non-electronic data sharing methods impact outcomes for individuals with SUD. Interoperable consent management, HIE and PDMP integration with EHRs, and harmonized privacy regulations are provider priorities. Conclusion Mapping provider-identified barriers reveals technical, regulatory, and workflow breakdowns that limit SUD care coordination. Advancing electronic, consent-driven interoperability employing standards is critical to improving continuity of care while safeguarding patient privacy.
M. Kaiser, Mengyi Wei, Sai Prathyusha Nookala et al.· JAMIA Open· 0 citations
Substance Use Disorder (SUD) treatment in sub-Saharan Africa remains poorly understood from the perspectives of those who deliver and receive it. We integrated the perspectives of service users (SUs) and front-line health care workers (HCWs) within a single analytic frame to map SUD treatment trajectories and identify multilevel barriers and facilitators shaping treatment and recovery outcomes in Uganda. We conducted a qualitative study nested within a parent cohort of adults treated for SUDs at two public treatment facilities in Uganda. We conducted in-depth interviews with 43 SUs from this cohort and 10 HCWs directly involved in SUD care. We analysed the data using reflexive thematic analysis. SU and HCW data accounts were first analysed separately before applying integrative mapping to generate cross-cutting meta-themes. We identified four interrelated meta-themes. First, systemic and structural constraints, including human resource gaps, medication stockouts, and inadequate infrastructure, undermined care consistency and quality. Second, accounts suggested that SUD care was only partially aligned with the biopsychosocial model, with acute biomedical stabilisation more consistently implemented than psychosocial support, individualised care, and recovery planning. Third, participants described returning to high-risk post-treatment environments marked by stigma, weak family support, peer and environmental triggers, economic insecurity, and untreated comorbidities, which increased perceived relapse vulnerability. Fourth, they identified supportive anchors for recovery, including faith and spirituality, active coping, family and community engagement, peer mentorship, task-sharing, and strengthened multidisciplinary care. Participants’ accounts indicate that SUD care and recovery in Uganda are shaped by a self-reinforcing cycle of system constraints, fragmented care, and high-risk post-discharge environments. Reorienting SUD care towards a recovery-oriented continuum will require stronger links between facility-based treatment and community support, alongside investment in psychosocial care, workforce capacity, service infrastructure, and locally available recovery resources.
C. Biribawa, W. Vanderplasschen, J. Mutyoba et al.· PLOS Global Public Health· 0 citations
INTRODUCTION
Current best practice is for primary care physicians (PCPs) to screen patients for problematic substance use at checkups. However, this practice is not routine, is done in an unstandardized manner, and contributes to the overburdening of PCPs. Screening practices also target current, potentially problematic use behaviors, thus limiting their capacity to help patients prevent problems before they start. Recent scientific advances in identifying people at elevated risk for substance use problems as a means of facilitating prevention efforts have not yet been integrated into medical practice. To address these issues, our research team developed a freestanding platform called the Comprehensive Addiction Risk Evaluation System (CARES). CARES provides personalized information about genetic and behavioral/environmental risk for substance use disorder (SUD) and connects individuals to resources based on their risk profile. The present study evaluated the potential for adoption and implementation of CARES within a healthcare system through qualitative interviews with key stakeholders.
METHODS
Semi-structured interviews were developed using the Consolidated Framework for Implementation Research (CFIR) and conducted with N = 15 interviewees. Transcripts were analyzed using rapid qualitative analysis.
RESULTS
Key themes included perceived need for new SUD screening tools, current SUD screening procedures and their pros/cons, openness to new ideas and clinical tools, fit of CARES with organizational goals and priorities, considerations for use of CARES with adolescent populations, anticipated patient response to CARES, barriers to implementation and uptake of CARES, changes to CARES required for implementation, and possibility for integrating results from CARES into patient medical records. Interviewees generally expressed need for new screening tools and openness to using new tools, but expressed concern that existing provider burden, lack of SUD knowledge, and discomfort/stigma could stymie efforts to implement CARES.
CONCLUSIONS
There is a clear need for a low-burden, easy-to-use tool for substance use prevention. CARES appears to be an acceptable and feasible approach to fill this gap. These findings will be used to inform pilot implementation of CARES in clinical care settings.
Genevieve F. Dash, E. Balcke, Holly Poore et al.· Journal of substance use and...· 0 citations
Introduction: The specific nature of occupational therapy interventions for substance-related disorders in South African primary health care settings remain unclear, despite these disorders posing significant intersecting health and social challenges. The 2023 Prevention of and Treatment for Substance Use Disorders Policy emphasises a shift towards collaborative care, however it remains unclear how occupational therapists enact these directives. Methods: An exploratory qualitative study explored substance-related disorder interventions provided by occupational therapists in the City of Johannesburg’s public primary health care facilities. Purposive heterogeneous sampling was used to select eighteen participants consisting of occupational therapists (n=8), multidisciplinary team members (n=6) and service users (n=4). Semi-structured interviews were audio-recorded, written, transcribed verbatim and thematically analysed.Results: Six themes emerged: (1) individualised approaches to substance-related disorder interventions, (2) campaigns and screenings, (3) barriers to service delivery, (4) socioeconomic and contextual influences on substance use, (5) service users’ experiences with occupational therapy, and (6) proposed solutions for improved substance-related disorder interventions. Conclusion: Despite challenges in South African public health settings—such as underfunding and staff shortages—occupational therapists in primary health care settings provide numerous occupation-based interventions for substance-related disorders. These interventions address occupational performance in individual and group settings, with gardening groups being the most common form of group intervention.
Implications for practice: The findings suggest that occupational therapy interventions for substance-related disorders primarily focus on leisure, education, work, psychoeducation, coping skills development, and referrals to learnerships. However, health promotion and substance-related disorder prevention are often underemphasised. These findings highlight the need for occupational therapists to actively engage in health promotion, substance-related disorder prevention, and enhanced interprofessional collaboration to address these conditions more comprehensively.
Kirsty Ferrett, Phakeme Z. Mkhize, D. Mpanza· South African Journal of Occ...· 0 citations
To address the increasingly potent unregulated drug supply and the complex withdrawal syndromes that accompany it, a hospital-based withdrawal management unit was launched in September 2023 as part of Vancouver, Canada’s Road to Recovery (R2R) initiative. This study explores healthcare staff experiences working within the new unit to identify opportunities to improve clinical service delivery and working conditions.
This study employed a mixed method design. Between May and July 2024, R2R healthcare staff were invited to complete a cross-sectional survey to characterize their experiences working in a new hospital-based withdrawal management unit. A purposive sample of healthcare staff were selected to complete a one-time semi-structured qualitative interview between July and August 2024. Descriptive statistics were used to summarize survey data, while conventional content analysis was used to analyze qualitative data.
Thirty-three healthcare staff completed the study’s cross-sectional survey, including clinicians (e.g., nurses, physicians, pharmacists) and other staff such as social workers, peer support specialists, and Indigenous Wellness Liaisons (IWLs). Overall, 97% (
n
= 32) reported feeling satisfied with their role at R2R. Most respondents felt the model of care was well-rounded (82%,
n
= 27), trauma-informed (82%,
n
= 27), culturally and spiritually sensitive (85%,
n
= 28), and safe (94%,
n
= 31). Qualitative interviews (
n
= 8) revealed a consistent sense of pride in delivering ‘recovery-oriented’ care. Participants also felt R2R care provision was individualized, high-quality, and promoted meaningful engagement with patients through the cultivation of a safe environment. Job satisfaction was linked with feeling autonomous in providing patients access to a comprehensive spectrum of substance use services. Integration of traditional healing practices, as well as the incorporation of unique provider roles including peer support specialists and IWLs were identified as unique factors contributing to positive work experiences. Areas identified to be challenges included overly rigid approaches to patient care following relapses to substance use, as well as ongoing shortages of experienced, culturally safe healthcare staff, contributing to capacity constraints and burnout in the midst of the ongoing toxic drug crisis.
Overall, healthcare staff reported job satisfaction working in a new hospital-based withdrawal management unit. Furthermore, participants described the R2R model of care as comprehensive, trauma-informed, and culturally safe.
Ava Abramowich, Piper Dickhout, Seonaid Nolan et al.· Addiction Science & Clin...· 0 citations
We use cookies to run the site and, with your consent, for analytics and to show ads.
See our Cookie Policy.
