A Cross-Sectional Study on Client Satisfaction of Opioid Substitution Therapy (OST) in a Tertiary Care Hospital of Punjab, India

TL;DR

This study assesses client satisfaction with opioid substitution therapy in a hospital in Punjab, India, finding generally satisfactory results but areas needing improvement.

Contribution

The study provides new insights into client satisfaction with OST in India, highlighting gaps in participation and psychosocial support.

Findings

Most clients rated information, decision making, and treatment results positively, but participation and caregiver standards were lacking.

Lower GGZ scores correlated with higher buprenorphine+naloxone doses and longer OST duration.

Clients reported challenges like needing advanced doses and difficulty with daily visits.

Abstract

Introduction: Opioid substitution therapy (OST) program under the National Aids Control Organization (NACO), India, is a harm-reduction approach targeting injectable opioid use. However, this ‘one-size-fits-all’ approach may potentially deter client satisfaction. Scant data on service quality in India warranted the current research.

Methods: This was a cross-sectional study in one OST center at a tertiary-care hospital in Punjab, India. Socio-demographic details of registered OST clients were collected. Client satisfaction was assessed using the GGZ (Geestelijke Gezondheidszorg; Dutch: mental healthcare) Thermometer.

Results: A total of 142 clients participated. Mean quality score was 7.6±1.5 (satisfactory). Positive rating was given by 93.7%, 46.5%, 61.3%, and 97.2% of clients for information, decision making, care provider, and treatment result domains, respectively. An open question regarding quality revealed ‘requirement of advanced doses’ by 24.6% and ‘difficulty in daily visits’ by 11.3%. GGZ score negatively correlated with current buprenorphine+naloxone (BPN) dose (r=-0.17, p=0.046). Those with a <6 score had a longer duration on OST (p=0.011), which positively correlated with starting BPN dose (r=0.43, p<0.001).

Conclusion: It was concluded that the center performed satisfactorily at providing information and treatment results, but lacked in client participation and caregiver standards. Individual tailoring of treatment and enhancing on-site psychosocial support is needed to improve quality.

Figures