Primary Care Provider expectations of addiction services and patients in Spain.

Background: Primary care (PC) is crucial in the care of substance use disorder (SUD) patients. However, the relationship between primary care and addiction settings is complex and collaboration issues stand out. Available evidence suggests that integration of SUD and PC services can improve physical and mental health of SUD patients and reduce health expenses.

Objective: To explore the experiences, views and attitudes of PC professionals towards the interaction between PC and SUD services.

Methods: Twenty-seven general practitioners (GPs) took part in three focus groups. The focus group sessions were audio-taped, transcribed verbatim and analyzed using reflexive thematic analysis. Recurrent themes were identified.

Results: Four main themes were devised: (1) Differences and specificities of SUD patients, (2) Interaction between providers of primary care and addiction services, (3) Patient management (4) Addiction stigma. These main themes reflect the consideration that SUD patients are a specific group with specific care needs that yield specific challenges to GPs themselves. Improved training, availability of a shared medical record system, increased feedback between GP and addiction specialists and the efficiency of the circuit are to be considered the main priority for the majority of the participants.

Conclusions: An efficient and effective referral circuit, with increased feedback and shared medical records is considered key to GPs. Its implementation should keep in mind the specific features of both SUD patients and GPs