Establishing the impact of consumer participation in alcohol and other drug treatment settings in Australia

Involvement of people who use alcohol and other drug services in the development of patient-reported measures of experience: A scoping review

INTRODUCTION

Patient-reported measures that assess satisfaction and experience are increasingly utilised in healthcare sectors, including the alcohol and other drug (AOD) sector. This scoping review identifies how and to what extent people accessing AOD services have been involved in the development of satisfaction and experience measures to date.

METHODS

PubMed, EMBASE, CINAHL, Scopus, ProQuest, Google and Google Scholar were searched. Included papers described the development and/or implementation of a multiple-item measure of patient-reported experience or satisfaction specifically for people accessing AOD treatment and/or harm reduction programmes. If there was more than one paper, key papers were chosen that described each measure. The method of development, including service user involvement, was assessed against a framework generated for this review. Two reviewers were involved at each stage.

RESULTS

Thirty measures-23 satisfaction and 7 experience-were identified. Sixteen measures reported some level of involvement by people accessing AOD services in their development, although, for most measures, at a relatively low level. This involvement increased over the time span of the review becoming more frequent in later years. Only four measures were developed for use in harm reduction-specific settings, and fewer than half reported undertaking analysis of underlying scale structure and constructs.

CONCLUSION

Several gaps could be addressed to enhance the measurement of patient-centred care in the AOD sector, including: developing experience measures for use in harm reduction settings and across various AOD settings in a service system; improved reporting of psychometric properties of these measures and increasing commitment to the meaningful involvement of AOD service users in measure development.

PATIENT OR PUBLIC CONTRIBUTION

This scoping review is part of a broader codesign project that involves a partnership between the peak organisation for AOD services and the peer-based AOD consumer organisation in the Australian Capital Territory, Australia. These organisations are working closely together to engage with AOD service users, service providers and policy makers in this codesign project. As such, the Executive Director of the peer-based AOD consumer organisation is involved as a co-author of this scoping review.

Exploring the lived experiences of Indigenous Australians within the context of alcohol and other drugs treatment services: A scoping review

ISSUES

Substance use among Indigenous peoples has been extensively researched in the Australian context. However, syntheses of existing research focused on Indigenous Australian peoples' experiences of alcohol and other drug (AOD) treatment are limited. This review sought to fill this gap.

APPROACH

A scoping review using three databases, and the Google search engine, examined empirical and grey literature relating to Indigenous Australian peoples' lived experiences of accessing and undergoing AOD treatment. The review was not restricted to intervention type, treatment setting, substance, or individual characteristics (e.g., age or gender). The experiences of staff of Indigenous Australian service providers were excluded.

KEY FINDINGS

Twenty-seven articles were reviewed, with most research (n = 12) conducted in New South Wales. Our secondary analysis of existing research found three themes: the role of culture, the value of holistic strength-based services, and the influence of organisational components for Indigenous Australian service users in AOD treatment settings.

IMPLICATIONS AND CONCLUSION

Despite diversity of experiences, our review highlights the importance of integrating culture and facilitating holistic strength-based approaches to AOD treatment for Indigenous Australian peoples. While our review is limited by the findings and biases contained within the literature reviewed, the paucity of literature relating to the experiences of Indigenous Australian peoples within AOD treatment settings warrants further attention.

Optimising community health services in Australia for populations affected by stigmatised infections: What do service users want?

Stigma in health services undermines diagnosis, treatment and successful health outcomes for all communities, but especially for those affected by blood-borne viruses and sexually transmitted infections (STIs). This study sought to examine experiences in accessing and receiving health services, including what characteristics promoted better health, safety and well-being for people with blood-borne viruses or STIss. It conducted 46 in-depth interviews with people who inject drugs, gay men and other men who have sex with men, sex workers, people in custodial settings, culturally and linguistically diverse people, Indigenous Australians and young people in one Australian urban community setting. Findings reveal that stigma persists in the provision of healthcare services, and that previous experiences of discrimination or fear of mistreatment may result in a reluctance to continue to access services. On-going staff training and education are important to ensure healthcare environments are welcoming and inclusive. Specialised services and services that employed peers were seen as favourable. Attending different services for different health needs created particular access challenges and undermined participant ability to engage in more holistic healthcare. The fragmented structure of health services was thus seen as a barrier to accessing health services, and stronger collaboration between health services is recommended.