Abstract：
BACKGROUND: Conceptualisations of the \'patient journey\' are popular within health service research. Patient journeys provide a person-centred approach to health care that typically prioritise subjective patient experience with the aim of improving relevant forms of intervention. This article explores the conceptualisation of retention in treatment for opioid use disorder (OUD) using long-acting injectable buprenorphine (LAIB) as a journey.
METHODS: Data derive from a longitudinal qualitative study, involving semi-structured interviews (held at six time-points), with participants who each initiated LAIB for the first time. Data analysis for this article focuses exclusively upon the experiences of those who had continued with LAIB treatment throughout one year (11 participants). Framework and thematic narrative analyses of 64 interviews with 11 participants sought to identify \'retention-narratives\' that would indicate a \'retention journey\' associated with LAIB treatment.
RESULTS: Shared treatment experiences consisted of three distinct phases (Withdrawal and Separation, Transformation, and Engagement) that progressed in a linear and intersecting manner through time. Each phase had features that defined treatment experiences at a given time but changed as treatment progressed. All 11 participants experienced multiple features within each of the three treatment phases and all participants reported separation from their respective service provider throughout the first 12 months of treatment. Although some valued the latter separation, most were dissatisfied by reduced levels of contact.
CONCLUSIONS: Retention in treatment for OUD with LAIB, for at least 12-months, can be conceptualised as a journey. This conceptualisation emphasises the benefits (and challenges) clinicians and patients may expect to encounter during the first year of a LAIB treatment programme. An added implication of conceptualising LAIB treatment in this manner is that optimal benefits of the medication (as observed by participants) began to emerge during \'months 7-12\' of the retention journey.
METHODS: Data derive from a longitudinal qualitative study, involving semi-structured interviews (held at six time-points), with participants who each initiated LAIB for the first time. Data analysis for this article focuses exclusively upon the experiences of those who had continued with LAIB treatment throughout one year (11 participants). Framework and thematic narrative analyses of 64 interviews with 11 participants sought to identify \'retention-narratives\' that would indicate a \'retention journey\' associated with LAIB treatment.
RESULTS: Shared treatment experiences consisted of three distinct phases (Withdrawal and Separation, Transformation, and Engagement) that progressed in a linear and intersecting manner through time. Each phase had features that defined treatment experiences at a given time but changed as treatment progressed. All 11 participants experienced multiple features within each of the three treatment phases and all participants reported separation from their respective service provider throughout the first 12 months of treatment. Although some valued the latter separation, most were dissatisfied by reduced levels of contact.
CONCLUSIONS: Retention in treatment for OUD with LAIB, for at least 12-months, can be conceptualised as a journey. This conceptualisation emphasises the benefits (and challenges) clinicians and patients may expect to encounter during the first year of a LAIB treatment programme. An added implication of conceptualising LAIB treatment in this manner is that optimal benefits of the medication (as observed by participants) began to emerge during \'months 7-12\' of the retention journey.
摘要：
背景：“患者旅程”的概念在卫生服务研究中很受欢迎。患者旅程提供了以人为中心的医疗保健方法，通常优先考虑主观患者体验，以改善相关的干预形式。本文探讨了使用长效注射用丁丙诺啡（LAIB）作为旅程的阿片类药物使用障碍（OUD）治疗保留的概念化。
方法：数据来自纵向定性研究，涉及半结构化访谈(在六个时间点举行)，每个参与者都是第一次发起LAIB。本文的数据分析仅集中在那些在一年中继续接受LAIB治疗的人（11名参与者）的经验上。对11名参与者进行的64次访谈的框架和主题叙事分析试图确定“保留叙事”，这将表明与LAIB治疗相关的“保留之旅”。
结果：共同的治疗经验包括三个不同的阶段（退出和分离，转型,和参与度)随着时间的推移以线性和交叉的方式进展。每个阶段都有在给定时间定义治疗经验的特征，但随着治疗的进展而改变。所有11名参与者在三个治疗阶段中的每个阶段都经历了多种特征，并且所有参与者报告在治疗的前12个月中与各自的服务提供商分离。尽管有些人重视后者的分离，大多数人对接触水平的降低不满意。
结论：LAIB治疗OUD的保留，至少12个月,可以被概念化为一个旅程。这种概念化强调了临床医生和患者在LAIB治疗计划的第一年可能会遇到的好处（和挑战）。以这种方式概念化LAIB治疗的另一个含义是，药物的最佳益处（如参与者所观察到的）在保留旅程的7-12个月中开始出现。
方法：数据来自纵向定性研究，涉及半结构化访谈(在六个时间点举行)，每个参与者都是第一次发起LAIB。本文的数据分析仅集中在那些在一年中继续接受LAIB治疗的人（11名参与者）的经验上。对11名参与者进行的64次访谈的框架和主题叙事分析试图确定“保留叙事”，这将表明与LAIB治疗相关的“保留之旅”。
结果：共同的治疗经验包括三个不同的阶段（退出和分离，转型,和参与度)随着时间的推移以线性和交叉的方式进展。每个阶段都有在给定时间定义治疗经验的特征，但随着治疗的进展而改变。所有11名参与者在三个治疗阶段中的每个阶段都经历了多种特征，并且所有参与者报告在治疗的前12个月中与各自的服务提供商分离。尽管有些人重视后者的分离，大多数人对接触水平的降低不满意。
结论：LAIB治疗OUD的保留，至少12个月,可以被概念化为一个旅程。这种概念化强调了临床医生和患者在LAIB治疗计划的第一年可能会遇到的好处（和挑战）。以这种方式概念化LAIB治疗的另一个含义是，药物的最佳益处（如参与者所观察到的）在保留旅程的7-12个月中开始出现。
