title: Waiting room ambience and provision of opioid substitution therapy in general practice.
abstract: OBJECTIVE
  To assess whether patients receiving opioid substitution therapy (OST) in general practice cause other patients sufficient distress to change practices--a perceived barrier that prevents general practitioners from prescribing OST.
  
  
  METHODS
  A cross-sectional questionnaire-based survey of consecutive adult patients in the waiting rooms of a network of research general practices in New South Wales during August-December 2009.
  
  
  METHODS
  Prevalence of disturbing waiting room experiences where drug intoxication was considered a factor, discomfort about sharing the waiting room with patients being treated for drug addiction, and likelihood of changing practices if the practice provided specialised care for patients with opiate addiction.
  
  
  RESULTS
  From 15 practices (eight OST-prescribing), 1138 of 1449 invited patients completed questionnaires (response rate, 78.5%). A disturbing experience in any waiting room at any time was reported by 18.0% of respondents (203/1130), with only 3.1% (35/1128) reporting that drug intoxication was a contributing factor. However, 39.3% of respondents (424/1080) would feel uncomfortable sharing the waiting room with someone being treated for drug addiction. Respondents were largely unaware of the OST-prescribing status of the practice (12.1% of patients attending OST-prescribing practices [70/579] correctly reported this). Only 15.9% of respondents (165/1037) reported being likely to change practices if theirs provided specialised care for opiate-addicted patients. In contrast, 28.7% (302/1053) were likely to change practices if consistently kept waiting more than 30 minutes, and 26.6% (275/1033) would likely do so if consultation fees increased by $10.
  
  
  CONCLUSIONS
  Despite the frequency of stigmatising attitudes towards patients requiring treatment for drug addiction, GPs' concerns that prescribing OST in their practices would have a negative impact on other patients' waiting room experiences or on retention of patients seem to be unfounded.
authors.affiliation: Albert Street Medical Centre, Taree, NSW. simon@nunet.com.au
authors.forename: Simon M
authors.initials: SM
authors.lastname: Holliday
authors.forename: Parker J
authors.initials: PJ
authors.lastname: Magin
authors.forename: Janet S
authors.initials: JS
authors.lastname: Dunbabin
authors.forename: Ben D
authors.initials: BD
authors.lastname: Ewald
authors.forename: Julie-Marie
authors.initials: JM
authors.lastname: Henry
authors.forename: Susan M
authors.initials: SM
authors.lastname: Goode
authors.forename: Fran A
authors.initials: FA
authors.lastname: Baker
authors.forename: Adrian J
authors.initials: AJ
authors.lastname: Dunlop
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions; D058006:General Practice / Q000379:methods*; D006801:Humans; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009517:New South Wales / Q000453:epidemiology; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000453:epidemiology; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D009292:Narcotic Antagonists