# 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.

## Key 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.