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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. [ABSTRACT FROM AUTHOR]

Background: People who use drugs (PWUD) frequently delay or avoid obtaining medical care in traditional healthcare settings. Through a randomized controlled trial, we investigated facilitated telemedicine for hepatitis C virus (HCV) integrated into opioid treatment programmes. We sought to understand the experiences and meanings of facilitated telemedicine and an HCV cure among PWUD. Methods: We utilized purposive sampling to interview 25 participants, 6–40 months after achieving an HCV cure. We interpreted and explicated common meanings of participants' experiences of an HCV cure obtained through facilitated telemedicine. Results: Participants embraced facilitated telemedicine integrated into opioid treatment programmes as patient‐centred care delivered in 'safe spaces' (Theme 1). Participants elucidated their experiences of substance use and HCV while committing to treatment for both entities. Facilitated telemedicine integrated into opioid treatment programmes enabled participants to avoid stigma encountered in conventional healthcare settings (Theme 2). Participants conveyed facing negative perceptions of HCV and substance use disorder. Improved self‐awareness, acquired through HCV and substance use treatment, enabled participants to develop strategies to address shame and stigma (Theme 3). An HCV cure, considered by PWUD as a victory over a lethal infectious disease, promotes self‐confidence, enabling participants to improve their health and lives (Theme 4). Conclusions: Integrating facilitated telemedicine into opioid treatment programmes addresses several healthcare barriers for PWUD. Similarly, obtaining an HCV cure increases their self‐confidence, permissive to positive lifestyle changes and mitigating the negative consequences of substance use. Patient and Public Contribution: In this study of patient involvement, we interviewed patient‐participants to understand the meaning of an HCV cure through facilitated telemedicine. Participants from a facilitated telemedicine pilot study provided essential input on the design and outcomes of a randomized controlled trial. Pilot study participants endorsed facilitated telemedicine in a testimonial video. They attended site initiation meetings to guide trial implementation. A Patient Advisory Committee (PAC) ensured that patient participants were active members of the research team. The PAC represented patients' voices through feedback on study procedures. A Sustainability Committee supported public involvement in the research process, including educational opportunities, feedback on implementation, and future sustainability considerations. [ABSTRACT FROM AUTHOR]

Policy PointsAs a consequence of mass incarceration and related social inequities in the United States, jails annually incarcerate millions of people who have profound and expensive health care needs.Resources allocated for jail health care are scarce, likely resulting in treatment delays, limited access to care, lower‐quality care, unnecessary use of emergency medical services (EMS) and emergency departments (EDs), and limited services to support continuity of care upon release.Potential policy solutions include alternative models for jail health care oversight and financing, and providing alternatives to incarceration, particularly for those with mental illness and substance use disorders. Context: Millions of people are incarcerated in US jails annually. These individuals commonly have ongoing medical needs, and most are released back to their communities within days or weeks. Jails are required to provide health care but have substantial discretion in how they provide care, and a thorough overview of jail health care is lacking. In response, we sought to generate a comprehensive description of jails' health care structures, resources, and delivery across the entire incarceration experience from jail entry to release. Methods: We conducted in‐depth interviews with jail personnel in five southeastern states from August 2018 to February 2019. We purposefully targeted recruitment from 34 jails reflecting a diversity of sizes, rurality, and locations, and we interviewed personnel most knowledgeable about health care delivery within each facility. We coded transcripts for salient themes and summarized content by and across participants. Domains included staffing, prebooking clearance, intake screening and care initiation, withdrawal management, history and physicals, sick calls, urgent care, external health care resources, and transitional care at release. Findings: Ninety percent of jails contracted with private companies to provide health care. We identified two broad staffing models and four variations of the medical intake process. Detention officers often had medical duties, and jails routinely used community resources (e.g., emergency departments) to fill gaps in on‐site care. Reentry transitional services were uncommon. Conclusions: Jails' strategies for delivering health care were often influenced by a scarcity of on‐site resources, particularly in the smaller facilities. Some strategies (e.g., officers performing medical duties) have not been well documented previously and raise immediate questions about safety and effectiveness, and broader questions about the adequacy of jail funding and impact of contracting with private health care companies. Beyond these findings, our description of jail health care newly provides researchers and policymakers a common foundation from which to understand and study the delivery of jail health care. [ABSTRACT FROM AUTHOR]

Objective: To assess frequency, type, and extent of behavioral health (BH) nonquantitative treatment limits (NQTLs) before and after implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).Data Sources: Secondary administrative data for Optum carve-out and carve-in plans.Study Design: Cross-tabulations and "two-part" regression models were estimated to assess associations of parity period with NQTLs.Data Collection/extraction Methods: Optum provided four proprietary BH databases, including 2008-2013 data for 40 carve-out and 385 carve-in employers from Optum's claims processing databases and 2010 data from interviews conducted by Optum's parity compliance team with 49 carve-out employers.Principal Findings: Preparity, carve-out plans required preauthorization for in-network inpatient/intermediate care; otherwise coverage was denied. Postparity, 73 percent would review later by request and half charged no penalty for late authorization. Outpatient visit authorization requirements virtually disappeared. For carve-out out-of-network inpatient/intermediate care, and for carve-ins, plans changed penalties to match medical service policies, but this did not necessarily lead to fewer requirements or lower penalties.Conclusion: After 2011, MHPAEA was associated with the transformation of BH care management, including much less restrictive preauthorization requirements, especially for in-network care provided by carve-out plans. [ABSTRACT FROM AUTHOR]

Objective: To examine the influence of Oregon's coordinated care organizations (CCOs) and pay-for-performance incentive model on completion of screening and brief intervention (SBI) and utilization of substance use disorder (SUD) treatment services.Data Sources/study Setting: Secondary analysis of Medicaid encounter data from 2012 to 2015 and semiannual qualitative interviews with stakeholders in CCOs.Study Design: Longitudinal mixed-methods design with simultaneous data collection with equal importance.Data Collection/extraction Methods: Qualitative interviews were recorded, transcribed, and coded in ATLAS.ti. Quantitative data included Medicaid encounters 30 months prior to CCO implementation, a 6-month transition period, and 30 months following CCO implementation. Data were aggregated by half-year with analyses restricted to Medicaid recipients 18-64 years of age enrolled in a CCO, not eligible for Medicare coverage or Medicaid expansion.Principal Findings: Quantitative analysis documented a significant increase in SBI rates coinciding with CCO implementation (0.1 to 4.6 percent). Completed SBI was not associated with increased initiation in treatment for SUD diagnoses. Qualitative analysis highlighted importance of aligning incentives, workflow redesign, and leadership to facilitate statewide SBI.Conclusions: Results provide modest support for use of a performance metric to expand SBI in primary care. Future research should examine health reform efforts that increase initiation and engagement in SUD treatment. [ABSTRACT FROM AUTHOR]