The relationship between patient-centered care and outcomes in specialist drug and alcohol treatment: A systematic literature review

Abstract

Background: Patient-centered care is strongly advocated as a key for improving the quality of healthcare. Research examining the impact of patient-centered care in healthcare has concluded that there are demonstrable albeit inconsistent relationships between patient experience, quality of care, and healthcare outcomes. Knowledge of the impact of patient-centered care in the treatment of substance use disorder is limited. The aim of this review was to assess relationships between indicators of patient-centered care (satisfaction and patient-reported experience measures) and patient outcomes (substance use, psychological wellbeing, and service use) among people attending treatment for substance use disorder. Methods: A systematic electronic literature search of a range of databases was conducted with variations of the search terms ‘patient-centered care’, ‘substance use disorders’, and residential or community specialist ‘treatment’. The populations, interventions and outcomes were summarized and described according to the PRISMA statement. Results: A total of 25 articles were identified, of which only five included a patient-centered indicator other than satisfaction. Indicators of patient-centered care showed a generally positive association with improved outcomes, particularly between satisfaction with treatment and substance use. Nonetheless, mixed and contradictory results were not uncommon, more so for psychological wellbeing outcomes. Conclusions: There were demonstrable relationships between patient-centered indicators and outcomes for people receiving treatment for substance use disorder. However, conclusions are limited due to underrepresentation of patient-reported experience measures. Further research in the area is needed involving comparisons of patient centered indicators with outcomes and use of patient-reported experience measures together with satisfaction.

Registration number: CRD42018092829

Keywords:

• Patient-centered care
• satisfaction
• patient-reported experience
• substance use
• systematic review

Author contributions

ED contributed to the review conception and design, collection of data, analysis, interpretation of the results, writing and revision of the manuscript. PK and FD contributed to the review conception and design, interpretation of the results, writing and revision of the manuscript. AB and MB contributed to the review design, interpretation of the results and revisions to the manuscript. TD contributed to the analysis, interpretation of results and revision of the manuscript. SA contributed to the interpretation of the results and revision to the manuscript. All authors approved the submitted manuscript.

Disclosure statement

The authors declare no conflicts of interest with respect to the research, authorship, and/or publication of this article.

Additional information

Funding

This work was supported by the NSW Health AOD Early Intervention Innovation Fund under Non-government Organization Evaluation Grant [H17/2775]. The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.