Why use group visits for opioid use disorder treatment in primary care? A patient-centered qualitative study.
BACKGROUND
Primary care providers are well positioned to respond to the opioid crisis by providing buprenorphine/naloxone (B/N) through shared medical appointments (SMAs). Although quantitative research has been previously conducted on SMAs with B/N, the authors conducted a qualitative assessment from the patients' point of view, considering whether and how group visits provide value for patients.


METHODS
Twenty-five participants with opioid use disorder (OUD) who were enrolled in a weekly B/N group visit at a family medicine clinic participated in either of two 1-hour-long focus groups, which were conducted as actual group visits. Participants were prompted with the question "How has this group changed you as a person?" Data were audio-recorded and professionally transcribed and analyzed using a qualitative thematic approach, identifying common communication behaviors and resulting attitudes about the value of the group visit model.


RESULTS
Participants demonstrated several communication behaviors that support group members in their recovery, including offering direct emotional support to others struggling with difficult experiences, making an intentional effort to probe about others' lives, venting about heavy situations, joking to lighten the mood, and expressing feelings of gratitude to the entire group. These communication behaviors appear to act as mechanisms to foster a sense of accountability, a shared identity, and a supportive community. Other demonstrated group behaviors may detract from the value of the group experience, including side conversations, tangential comments, and individual participants disproportionately dominating group time.


CONCLUSION
The group visit format for delivering B/N promotes group-specific communication behaviors that may add unique value in supporting patients in their recovery. Future research should elucidate whether these benefits can be isolated from those achieved solely through medication treatment with B/N and if similar benefits could be achieved in non-primary care sites.
['Sokol|Randi|R|', 'Albanese|Chiara|C|', 'Chaponis|Deviney|D|', 'Early|Jessica|J|', 'Maxted|George|G|', 'Morrill|Diana|D|', 'Poirier|Grace|G|', 'Puopolo|Fran|F|', 'Schuman-Olivier|Zev|Z|']
D000328:Adult D001071:Appointments and Schedules D000069479:Buprenorphine, Naloxone Drug Combination D005260:Female D017144:Focus Groups D006801:Humans D008297:Male D008875:Middle Aged D009293:Opioid-Related Disorders D011320:Primary Health Care D036301:Qualitative Research D012657:Self-Help Groups
group visit opioid use disorder primary care Buprenorphine shared medical appointment