title: How clinicians manage access to opioid replacement therapy.
abstract: In Australia, people wait to access opioid replacement therapy (ORT). The aim of this study was to examine how clinicians (n = 35) prioritize consumers for opioid replacement therapy (ORT). The study used a methodology informed by a constructivist approach to grounded theory. Based on a scenario related to two consumers seeking admission to opioid replacement therapy (ORT), participants were asked to prioritize one for preferential admission and questioned about their decision-making. Clinicians were neither confident nor unanimous in their decision-making. Team involvement and work experience influenced their judgment. Differences between clinicians in regard to understanding risks and protective factors were identified. To support uniformity in managing treatment requests, clearer policy direction to gui clinician practice, and further exploration of how models of care and team involvement influence consumer outcomes, are recommended.
authors.affiliation: Central Queensland University, Institute for Health and Social Science Research, Centre for Mental Health Nursing Innovation and School of Nursing and Midwifery, Rockhampton, Queensland, Australia.
authors.forename: Warren
authors.initials: W
authors.lastname: Harlow
authors.forename: Brenda
authors.initials: B
authors.lastname: Happell
authors.forename: Graeme
authors.initials: G
authors.lastname: Browne
mesh_terms: D000328:Adult; D001315:Australia; D005260:Female; D066296:Grounded Theory; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D008297:Male; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000188:drug therapy; D010818:Practice Patterns, Physicians'; D055815:Young Adult
keywords: access; management; opioid replacement therapy