Experiences of Team Collaboration in Primary Care-Based Delivery of Opioid Use Disorder Treatment.

Abstract

Team-based models of care delivery are increasingly utilized to address co-occurring mental health and/or substance use conditions. However, little is known about how team-based models function among primary care teams delivering treatment for opioid use disorder (OUD). The research team conducted qualitative interviews with a sample of multidisciplinary, primary care team members delivering OUD treatment using the collaborative care model (CoCM). Providers were recruited from 13 diverse United States (U.S.) clinics participating in a multisite hybrid effectiveness-implementation trial. Interviews were audio recorded and professionally transcribed. All transcripts were double-coded using a coding schema informed by relational coordination theory. Thirty-five team members completed an interview, including 14 primary care providers (PCPs), 13 behavioral health care managers (BHCM), and eight consulting psychiatric providers (CPP). Four themes emerged: (1) team-based work increases shared knowledge about patients; (2) team members leverage one another's relationships with patients to increase treatment engagement; (3) team collaboration is enhanced when BHCMs have opportunities and space to connect informally with PCPs; and (4) increased mutual respect between team members is needed to maximize patient engagement efforts. Team-based models may enhance patient engagement in OUD care by increasing the volume of patient contacts and augmenting therapeutic alliances.