Uncovering trajectories of satisfaction with injectable opioid agonist treatment for severe opioid use disorder

Background: For people with severe opioid use disorder (OUD), injectable opioid agonist treatment (iOAT), with hydromorphone or diacetylmorphine, is a safe and effective alternative to oral opioid agonist treatment. There is an increasing interest in patient reported experience measures (PREMs) in the field of addiction; one such approach is to measure client’s satisfaction. However, few studies have examined changes in perceived iOAT satisfaction over time and possible patient-level predictors associated with these trajectories.

Methods: RUTH (Research on the Utilization of Therapeutic Hydromorphone) was a prospective cohort study of 135 participants with severe OUD receiving iOAT in North America’s first program. Daily clinical record and bi-monthly self-report measures were collected over an 18-month follow-up period regarding participant’s treatment engagement (daily adherence, medication received, dose) self-reported outcomes (substance use, health, quality of life), and perceived treatment experience (satisfaction, qualitative perceptions). The outcome of interest, perceived treatment satisfaction, was measured with the Client Satisfaction Questionnaire (CSQ-8). Item and total mean CSQ-8 scores were calculated and compared using Student’s t and Mann-Whitney U tests depending on variable distribution. A two-level hierarchical linear model examined individual change in CSQ-8 scores associated with time-varying (treatment engagement and self-reported outcome variables) and time-invariant (participant baseline characteristics).

Results: Data analysis is in progress.

Conclusions: To our knowledge, this study will be the first to explore trajectories of treatment satisfaction with iOAT and their potential relationship with patient-level characteristics. Such data deepen understanding of changes in treatment satisfaction over time and can be used to strengthen the responsiveness of iOAT for people with severe OUD.