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Abstract
Aims: The International Survey Informing Greater Insights in Opioid Dependence Treatment (INSIGHT) study evaluated the implementation of opioid dependence treatment across different countries to assess treatment delivery, quality of care and outcomes. Methods: A questionnaire-based survey was used to gather data in nine countries across Central and Eastern Europe, South Africa and South-East Asia, from patients with opioid dependence receiving medication-assisted treatment (MAT), healthcare professionals (HCPs) who cared for opioid-dependent patients and opioid users not receiving MAT. Findings: There was substantial variation between countries, but overall results suggest that several aspects of MAT can be improved, such as access to treatment (conditions to start or remain in treatment), quality of care (availability/awareness of treatment options and appropriate medication dosing) and treatment outcomes (on-top use, misuse and diversion). Conclusions: This analysis highlights key priorities that should improve the quality of opioid dependence care and access to treatment. These priorities include: acknowledging opioid dependence as a chronic medical condition requiring long-term treatment; recognition by policymakers of the cost-effectiveness of treatment; making available, to those who want them, psychosocial interventions and educating HCPs to prescribe the safest, least divertible forms of medications available at optimal doses in order to reduce opioid use, misuse and diversion.
Acknowledgements
The authors would like to thank the physicians, nurses, patients, users, treatment centres and user support groups who participated. The survey used questionnaires based on those created by Professor Dr Heino Stöver, with additional input from the authors. The survey was funded by Reckitt Benckiser Pharmaceuticals. Chive Insight & Planning provided market research consultancy assistance. Market research and fieldwork was conducted by PSL and IPSOS, respectively; PSL analysed the data.
Details of ethics committee approvals, where required
Czech Republic: Ethics Committee of the General University Hospital Prague gave its approval for research (No. 2299/12 S-IV) on 14 December 2012. Israel: the patient arm of the survey was approved by institutional review board committee (BY-289) and patients signed an informed consent form in order to participate in this survey; physicians completed the survey voluntarily. Slovenia: the Medical Ethics Committee of the Republic of Slovenia gave its approval for research on 4 December 2012.
Notes
*All authors contributed equally to this work.