Transitioning From Detoxification to Substance Use Disorder Treatment: Facilitators and Barriers.
Although successful transitions from detoxification to substance use disorder treatment are associated with improved outcomes, many detoxification patients do not initiate treatment. This qualitative study informs detoxification and addiction treatment providers, and health systems, about how to improve detoxification to treatment transitions, by reporting detoxification providers' views of transition facilitators and barriers. The sample consisted of 30 providers from 30 Veterans Health Administration detoxification programs. Themes regarding transition facilitators and barriers emerged at the patient, program (detoxification programs, and addiction programs), and system levels. Detoxification program-level practices of discharge planning, patient education, and rapport building were reported as facilitating the transition to treatment. Six themes captured transition facilitators within addiction treatment programs: the provision of evidence-based practices, patient-centered care, care coordination, aftercare, convenience, and a well-trained and professional staff. This study expands previous literature on detoxification and addiction treatment by systematically and qualitatively examining factors that promote and hinder treatment initiation after inpatient and outpatient detoxification, from a provider perspective, in an era of health care reform and expanded substance use disorder treatment.
Center for Innovation to Implementation (Ci2i), Department of Veterans Affairs, Palo Alto Health Care System, Palo Alto, CA 94304, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA. Electronic address: Christine.Timko@va.gov.
Christine
C
Timko
Department of Psychology, Auburn University, Auburn, AL 36849, USA. Electronic address: nrs0011@auburn.edu.
Nicole R
NR
Schultz
Center for Innovation to Implementation (Ci2i), Department of Veterans Affairs, Palo Alto Health Care System, Palo Alto, CA 94304, USA; Clinical Psychology Graduate Program, Pacific Graduate School of Psychology-Stanford University Consortium, Palo Alto, CA 94304, USA. Electronic address: jbritt@paloaltou.edu.
Jessica
J
Britt
Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR 72205, USA; Veterans Affairs South Central (VISN 16) Mental Illness Research, Education, and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, AR 72205, USA; Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. Electronic address: Michael.Cucciare@va.gov.
Michael A
MA
Cucciare
D000328:Adult; D001291:Attitude of Health Personnel; D003266:Continuity of Patient Care / Q000592:standards*; D005260:Female; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D008297:Male; D008503:Medical Staff; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D018802:Patient-Centered Care / Q000592:standards*; D036301:Qualitative Research; D019966:Substance-Related Disorders / Q000628:therapy*; D014481:United States; D014493:United States Department of Veterans Affairs / Q000592:standards*; D014728:Veterans
Addiction; Care transitions; Detoxification; Providers; Qualitative; Treatment
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