Perspectives on extended-release naltrexone induction among patients living with HIV and opioid use disorder: a qualitative analysis

Abstract Background The CHOICES study randomized participants with HIV and opioid use disorder (OUD) to HIV clinic-based extended-release naltrexone (XR-NTX), which requires complete cessation of opioid use, versus treatment-as-usual (i.e., buprenorphine, methadone). Study participants randomized to...

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Autores principales:	Kim A. Hoffman, Robin Baker, Laura C. Fanucchi, Paula J. Lum, Lynn E. Kunkel, Javier Ponce Terashima, Dennis McCarty, Petra Jacobs, P. Todd Korthuis
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Extended-release naltrexone Opioid withdrawal Induction Opioid use disorder HIV Medicine (General) R5-920 Social pathology. Social and public welfare. Criminology HV1-9960
Acceso en línea:	https://doaj.org/article/2f820b33cf314209a1db427de7bc6add
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spelling	oai:doaj.org-article:2f820b33cf314209a1db427de7bc6add2021-11-14T12:37:04ZPerspectives on extended-release naltrexone induction among patients living with HIV and opioid use disorder: a qualitative analysis10.1186/s13722-021-00277-z1940-0640https://doaj.org/article/2f820b33cf314209a1db427de7bc6add2021-11-01T00:00:00Zhttps://doi.org/10.1186/s13722-021-00277-zhttps://doaj.org/toc/1940-0640Abstract Background The CHOICES study randomized participants with HIV and opioid use disorder (OUD) to HIV clinic-based extended-release naltrexone (XR-NTX), which requires complete cessation of opioid use, versus treatment-as-usual (i.e., buprenorphine, methadone). Study participants randomized to XR-NTX were interviewed to assess their experiences with successful and unsuccessful XR-NTX induction. Methods Semi-structured qualitative interviews were completed with a convenience sample of study participants with HIV and OUD (n = 37) randomized to XR-NTX in five HIV clinics between 2018 and 2019. All participants approached agreed to be interviewed. Interviews were digitally recorded, professionally transcribed, and analyzed using thematic analysis. Results Participants included women (43%), African Americans (62%) and Hispanics (16%), between 27 to 69 years of age. Individuals who completed XR-NTX induction (n = 20) reported experiencing (1) readiness for change, (2) a supportive environment during withdrawal including comfort medications, and (3) caring interactions with staff. Four contrasting themes emerged among participants (n = 17) who did not complete induction: (1) concern and anxiety about withdrawal including past negative experiences, (2) ambivalence about or reluctance to stop opioids, (3) concerns about XR-NTX effects, and (4) preferences for other medications. Conclusions The results highlight opportunities to improve initiation of XR-NTX in high-need groups. Addressing expectations regarding induction may enhance XR-NTX initiation rates. Trial Registration ClinicalTrials.gov: NCT03275350. Registered September 7, 2017. https://clinicaltrials.gov/ct2/show/NCT03275350?term=extended+release+naltrexone&cond=Opioid+Use .Kim A. HoffmanRobin BakerLaura C. FanucchiPaula J. LumLynn E. KunkelJavier Ponce TerashimaDennis McCartyPetra JacobsP. Todd KorthuisBMCarticleExtended-release naltrexoneOpioid withdrawalInductionOpioid use disorderHIVMedicine (General)R5-920Social pathology. Social and public welfare. CriminologyHV1-9960ENAddiction Science & Clinical Practice, Vol 16, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Extended-release naltrexone Opioid withdrawal Induction Opioid use disorder HIV Medicine (General) R5-920 Social pathology. Social and public welfare. Criminology HV1-9960
spellingShingle	Extended-release naltrexone Opioid withdrawal Induction Opioid use disorder HIV Medicine (General) R5-920 Social pathology. Social and public welfare. Criminology HV1-9960 Kim A. Hoffman Robin Baker Laura C. Fanucchi Paula J. Lum Lynn E. Kunkel Javier Ponce Terashima Dennis McCarty Petra Jacobs P. Todd Korthuis Perspectives on extended-release naltrexone induction among patients living with HIV and opioid use disorder: a qualitative analysis
description	Abstract Background The CHOICES study randomized participants with HIV and opioid use disorder (OUD) to HIV clinic-based extended-release naltrexone (XR-NTX), which requires complete cessation of opioid use, versus treatment-as-usual (i.e., buprenorphine, methadone). Study participants randomized to XR-NTX were interviewed to assess their experiences with successful and unsuccessful XR-NTX induction. Methods Semi-structured qualitative interviews were completed with a convenience sample of study participants with HIV and OUD (n = 37) randomized to XR-NTX in five HIV clinics between 2018 and 2019. All participants approached agreed to be interviewed. Interviews were digitally recorded, professionally transcribed, and analyzed using thematic analysis. Results Participants included women (43%), African Americans (62%) and Hispanics (16%), between 27 to 69 years of age. Individuals who completed XR-NTX induction (n = 20) reported experiencing (1) readiness for change, (2) a supportive environment during withdrawal including comfort medications, and (3) caring interactions with staff. Four contrasting themes emerged among participants (n = 17) who did not complete induction: (1) concern and anxiety about withdrawal including past negative experiences, (2) ambivalence about or reluctance to stop opioids, (3) concerns about XR-NTX effects, and (4) preferences for other medications. Conclusions The results highlight opportunities to improve initiation of XR-NTX in high-need groups. Addressing expectations regarding induction may enhance XR-NTX initiation rates. Trial Registration ClinicalTrials.gov: NCT03275350. Registered September 7, 2017. https://clinicaltrials.gov/ct2/show/NCT03275350?term=extended+release+naltrexone&cond=Opioid+Use .
format	article
author	Kim A. Hoffman Robin Baker Laura C. Fanucchi Paula J. Lum Lynn E. Kunkel Javier Ponce Terashima Dennis McCarty Petra Jacobs P. Todd Korthuis
author_facet	Kim A. Hoffman Robin Baker Laura C. Fanucchi Paula J. Lum Lynn E. Kunkel Javier Ponce Terashima Dennis McCarty Petra Jacobs P. Todd Korthuis
author_sort	Kim A. Hoffman
title	Perspectives on extended-release naltrexone induction among patients living with HIV and opioid use disorder: a qualitative analysis
title_short	Perspectives on extended-release naltrexone induction among patients living with HIV and opioid use disorder: a qualitative analysis
title_full	Perspectives on extended-release naltrexone induction among patients living with HIV and opioid use disorder: a qualitative analysis
title_fullStr	Perspectives on extended-release naltrexone induction among patients living with HIV and opioid use disorder: a qualitative analysis
title_full_unstemmed	Perspectives on extended-release naltrexone induction among patients living with HIV and opioid use disorder: a qualitative analysis
title_sort	perspectives on extended-release naltrexone induction among patients living with hiv and opioid use disorder: a qualitative analysis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/2f820b33cf314209a1db427de7bc6add
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Perspectives on extended-release naltrexone induction among patients living with HIV and opioid use disorder: a qualitative analysis

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