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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Can monitoring consumer requests for opioid-replacement therapy improve access to treatment?

Warren Harlow A B E , Brenda Happell A C , Graeme Browne D and Matthew Browne A
+ Author Affiliations
- Author Affiliations

A Central Queensland University Australia, Institute for Health and Social Science Research, Building 5, Bruce Highway Rockhampton, Qld 4702, Australia. Email: b.happell@cqu.edu.au, m.browne@cqu.edu.au

B Queensland Health Gold Coast Alcohol, Tobacco and Other Drugs Services, 2019 Gold Coast Highway, Miami, Qld 4220, Australia.

C School of Nursing and Midwifery, Building 5, Bruce Highway Rockhampton, Qld 4702, Australia.

D University of Newcastle Port Macquarie, University Drive, Callaghan, NSW 2308, Australia. Email: graeme.browne@newcastle.edu.au

E Corresponding author. Email: warren_harlow@health.qld.gov.au

Australian Health Review 38(3) 312-317 https://doi.org/10.1071/AH13212
Submitted: 1 November 2013  Accepted: 28 January 2014   Published: 8 May 2014

Abstract

Objective This study examined data recorded by one urban publicly funded opioid-replacement therapy clinic (from 2009 to 2011) to identify whether these data could be used to inform the rostering of clinicians more effectively to improve access to treatment.

Methods Data analysis incorporated descriptive and inferential methods.

Results There were trends in the times of the year consumers seek opioid-replacement therapy, similarity and differences between gender requests for treatment and variation in consumer wait time on triage.

Conclusions National reporting of opioid-replacement therapy triages would help gain a better understanding of the number of people in need of treatment. If opioid-replacement therapy providers monitored consumer triages, they could roster more effectively, have gender-specific clinicians available, acknowledge and inform consumers of wait time on triage and allow re-orientation of services to lower wait time.

What is known about the topic? National and state policies on opioid-replacement therapy provide limited guidance on the management of people waiting for treatment with no national triage system established. People wait for treatment, and how they are managed is largely unknown.

What does this paper add? This paper considers the process of monitoring people accessing opioid-replacement therapy treatment services to explore whether this can assist with processing people into treatment.

What are the implications for practitioners? This approach may assist practitioners to treat additional people by improving their resource management by spreading the consumer load evenly throughout the year and enabling the rostering of additional staff during recognised peak periods.

Additional keywords: management, wait time.


References

[1]  Australian Institute of Health and Welfare (AIHW). National opioid pharmacotherapy statistics annual data collection: 2011 report. Canberra: AIHW; 2012.

[2]  Australian Institute of Health and Welfare (AIHW). National opioid pharmacotherapy statistics annual data 2012 collection: data guide. Canberra: AIHW; 2012.

[3]  Ritter A, Chalmers J. Polygon: the many sides to the Australian opioid pharmacotherapy maintenance system. Canberra: Australian National Council on Drugs; 2009.

[4]  Lintzeris N. Prescribed medications: the new wave of opioid dependence. Of Substance: The National Magazine on Alcohol, Tobacco and Other Drugs 2009; 7 10–11.

[5]  Australian Institute of Health and Welfare (AIHW). AIHW national hospital morbidity database: separation, patient day and average length of stay statistics by principal diagnosis in ICD-10-AM, Australia, 1998–99 to 2007–08. Canberra: AIHW; 2010.

[6]  Australian Institute of Health and Welfare (AIHW). 2010 National drug strategy household survey report. Canberra: AIHW; 2011.

[7]  Leong M, Murnion B, Haber PS. Examination of opioid prescribing in Australia from 1992 to 2007. Intern Med J 2009; 39 676–81.
Examination of opioid prescribing in Australia from 1992 to 2007.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1Mjgsl2lsw%3D%3D&md5=7ed1194aa7eeb2a2df62081123c1cd80CAS | 19460051PubMed |

[8]  Duncan B. A rising tide. Of Substance: The National Magazine on Alcohol, Tobacco and Other Drugs 2012; 10 20–3.

[9]  Winstock A, Molan J, Lea T. Survey of New South Wales opioid treatment program public clinics: SWAT report 3. Contract No. 298. Sydney: National Drug and Alcohol Research Centre, University of New South Wales; 2008.

[10]  Drugs of Dependence Unit. DDU information circular: interim arrangement for patients pending admission to QOTP. Herston, Qld: Queensland Government; 2012.

[11]  Department of Health. New directions for alcohol and drug treatment services. Melbourne: Victorian Government; 2012.

[12]  Harlow W, Happell B, Browne G. Opioid replacement therapy: a wait unmanaged. Int J Ment Health Nurs 2011; 20 418–27.
Opioid replacement therapy: a wait unmanaged.Crossref | GoogleScholarGoogle Scholar | 21592273PubMed |

[13]  Gryczynski J, Schwartz RP, Salkever DS, Mitchell SG, Jaffe JH. Patterns in admission delays to outpatient methadone treatment in the United States. J Subst Abuse Treat 2011; 41 431–9.
Patterns in admission delays to outpatient methadone treatment in the United States.Crossref | GoogleScholarGoogle Scholar | 21821378PubMed |

[14]  Festinger DS, Lamb RJ, Kountz MR, Kirby KC, Marlowe D. Pretreatment dropout as a function of treatment delay and client variables. Addict Behav 1995; 20 111–15.
Pretreatment dropout as a function of treatment delay and client variables.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2MzgsV2qtw%3D%3D&md5=4935e7d957a8b75a237bd11cead80b49CAS | 7785476PubMed |

[15]  Guarino HM, Marsch LA, Campbell WS, Gargano SP, Haller DL, Solhkhah R. Methadone maintenance treatment for youth: experiences of clients, staff and parents. Subst Use Misuse 2009; 44 1979–89.
Methadone maintenance treatment for youth: experiences of clients, staff and parents.Crossref | GoogleScholarGoogle Scholar | 20001689PubMed |

[16]  Peterson JA, Schwartz RP, Mitchell SG, Reisinger HS, Kelly SM, O’Grady KE, et al Why don’t out-of-treatment individuals enter methadone treatment programmes? Int J Drug Policy 2010; 21 36–42.
Why don’t out-of-treatment individuals enter methadone treatment programmes?Crossref | GoogleScholarGoogle Scholar | 18805686PubMed |

[17]  Chalmers J, Ritter A, Heffernan M, McDonnell G. Modelling pharmacotherapy maintenance in Australia: exploring affordability, availability, accessibility and quality using system dynamics. In Chalmers J (Ed.). Drug Policy Modelling Program, University of New South Wales. Civic Square, ACT: Australian National Council on Drugs; 2009.

[18]  Bell J, Burrell T, Indig D, Gilmour S. Cycling in and out of treatment; participation in methadone treatment in NSW, 1990–2002. Drug Alcohol Depend 2006; 81 55–61.
Cycling in and out of treatment; participation in methadone treatment in NSW, 1990–2002.Crossref | GoogleScholarGoogle Scholar | 15993552PubMed |

[19]  Queensland Health. Rostering framework: best practice framework for rostering nursing personnel. Brisbane: Queensland Government; 2003.

[20]  Department of Health and Human Service Tasmania. Rostering guide for safe staffing. Hobart: Tasmanian Government; 2011.

[21]  Hallinan R, Osborn M, Cohen M, Dobbin M, Wodak A. Increasing the benefits and reducing the harms of prescription opioid analgesics. Drug Alcohol Rev 2011; 30 315–23.
| 21545563PubMed |

[22]  Hser Y, Maglione M, Polinsky ML, Anglin MD. Predicting drug treatment entry among treatment-seeking individuals. J Substance Treat 1998; 15 213–20.
Predicting drug treatment entry among treatment-seeking individuals.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1c3ps1Kruw%3D%3D&md5=ba8b65112395ae73e16b7c3c04d6874cCAS |

[23]  Eastern Perth Public and Community Health Unit. Responding to family and domestic violence: a guide for health care professionals in Western Australia. Perth: Western Australian Government; 2001.

[24]  Grigg M, Herrman H, Harvey C. What is duty/triage? Understanding the role of duty/triage in an area mental health service. Aust N Z J Psychiatry 2002; 36 787–91.
What is duty/triage? Understanding the role of duty/triage in an area mental health service.Crossref | GoogleScholarGoogle Scholar | 12406121PubMed |

[25]  Glancy GD, Chaimowitz G. The clinical use of risk assessment. Can J Psychiatry 2005; 50 12–7.
| 15754660PubMed |