{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:38:16Z","timestamp":1791290296299,"version":"4.3.0"},"reference-count":61,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T00:00:00Z","timestamp":1610409600000},"content-version":"unspecified","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["PJT-156306"],"award-info":[{"award-number":["PJT-156306"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["SHI-155404"],"award-info":[{"award-number":["SHI-155404"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,12,15]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Existing methods of measuring effectiveness of pharmacological treatment for opioid use disorder (OUD) are highly variable. Therefore, understanding patients\u2019 treatment goals is an integral part of patient-centred care. Our objective is to explore whether patients\u2019 treatment goals align with a frequently used clinical outcome, opioid abstinence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Triangulation mixed-methods design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and participants<\/jats:title>\n                    <jats:p>We collected prospective data from 2030 participants who were receiving methadone or buprenorphine-naloxone treatment for a diagnosis of OUD in order to meet study inclusion criteria. Participants were recruited from 45 centrally-managed outpatient opioid agonist therapy clinics in Ontario, Canada. At study entry, we asked, \u2018What are your goals in treatment?\u2019 and used NVivo software to identify common themes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measure<\/jats:title>\n                    <jats:p>Urine drug screens (UDS) were collected for 3 months post-study enrolment in order to identify abstinence versus ongoing opioid use (mean number of UDS over 3 months=12.6, SD=5.3). We used logistic regression to examine the association between treatment goals and opioid abstinence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants had a mean age of 39.2 years (SD=10.7), 44% were women and median duration in treatment was 2.6 years (IQR 5.2). Six overarching goals were identified from patient responses, including \u2018stop or taper off of treatment\u2019 (68%), \u2018stay or get clean\u2019 (37%) and \u2018live a normal life\u2019 (14%). Participants reporting the goal \u2018stay or get clean\u2019 had lower odds of abstinence at 3 months than those who did not report this goal (OR=0.73, 95%\u2009CI 0.59 to 0.91, p=0.005). Although the majority of patients wanted to taper off or stop medication, this goal was not associated with opioid abstinence, nor were any of their other goals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patient goals in OUD treatment do not appear to be associated with programme measures of outcome (ie, abstinence from opioids). Future studies are needed to examine outcomes related to patient-reported treatment goals found in our study; pain management, employment, and stopping\/tapering treatment should all be explored.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-044017","type":"journal-article","created":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T04:53:24Z","timestamp":1633064004000},"page":"e044017","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Are patients\u2019 goals in treatment associated with expected treatment outcomes? Findings from a mixed-methods study on outpatient pharmacological treatment for opioid use disorder"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7406-4056","authenticated-orcid":false,"given":"Tea","family":"Rosic","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Health Research, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0994-1109","authenticated-orcid":false,"given":"Leen","family":"Naji","sequence":"additional","affiliation":[{"name":"Department of Health Research, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balpreet","family":"Panesar","sequence":"additional","affiliation":[{"name":"Neurosciences Graduate Program, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren B","family":"Chai","sequence":"additional","affiliation":[{"name":"Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5883-1873","authenticated-orcid":false,"given":"Nitika","family":"Sanger","sequence":"additional","affiliation":[{"name":"Medical Science Gradaute Program, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany B","family":"Dennis","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C","family":"Marsh","sequence":"additional","affiliation":[{"name":"Northern Ontario School of Medicine, Sudbury, Ontario, Canada"},{"name":"Canadian Addiction Treatment Centres, Markham, Ontario, Canada"},{"name":"ICES North, Sudbury, Ontario, Canada"},{"name":"Health Sciences North Research Institute, Sudbury, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Launette","family":"Rieb","sequence":"additional","affiliation":[{"name":"Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Worster","sequence":"additional","affiliation":[{"name":"Department of Health Research, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lehana","family":"Thabane","sequence":"additional","affiliation":[{"name":"Department of Health Research, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada"},{"name":"Biostatistics Unit, Research Institute at St Joseph\u2019s Healthcare, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5974-9361","authenticated-orcid":false,"given":"Zainab","family":"Samaan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Health Research, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,1,12]]},"reference":[{"key":"2025121603323726000_11.1.e044017.1","unstructured":"Special Advisory Committee on the Epidemic of Opioid Overdoses . 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