• Evaluating the Patient Experience in Outpatient Detoxification: Implications for Improvement of the Early Stages of Alcohol and/or Opioid Use Disorder and Recovery Treatment Processs

      Ampong, David Nana (University of Alaska Anchorage, 2021-05-01)
      Background and Literature Review: Anchorage is among the cities besieged by the alcohol and opioid crisis. The city has numerous outpatient MAT programs and substance treatment settings that can provide outpatient detoxification programs. Although the literature supports outpatient detoxification as feasible, safe, and affordable, it does not provide a specific model of outpatient detoxification. The Alaska Treatment Center (ATC) offers outpatient detoxification based on a biopsychosocial model of detoxification. Since the ATC outpatient detoxification seeks to expand treatment through this model, it is necessary to evaluate the patients’ experiences to improve clinical practice and substance treatment. Purpose: This project aimed to evaluate patient experiences in outpatient detoxification at ATC and identify promising strategies for improvement of the model to formulate strategic practice advancement using empirical data from participants. Methods: The project was quasi-experimental in design and informed by Lewin’s three stage change model. Descriptive statistics of demographic and survey responses were presented using frequencies and percentages for categorical and ordinal variables. A 45-item survey collapsed into three areas: the initial encounter, relationship during treatment, and overall impression. A spearman’s rank correlation was conducted to test the internal consistency and construct validity of the instrument. Statistical significance was set at p ≤ .05. All analyses were conducted using SPSS Version 26. Implementation Plan/Procedure: The Generic Short Patient Experiences Questionnaire (GSPEQ) was modified and approved for use in this project by the University of Alaska Anchorage Institutional Review Board. The survey instrument was administered to 42 participants who received outpatient detoxification from ATC. The findings revealed successful completion rate of detoxification, with a significant correlation between before detoxification, rho = 0.1414, p = .007, and after detoxification, rho = -0.439, p = .769. Conclusion: The findings led to a modification of the ATC biopsychosocial model to encompass theoretical, contextual, conceptual, systematical, empirical, and implementational analysis. Consequently, flow charts, modified decision trees, and theory of change were integrated into the ATC policies and the electronic medical record. The project revealed that detoxification is a vital step in substance treatment and may be successfully provided in outpatient treatment settings using the right model of treatment. Organizational changes such as hiring additional staff and sharing the model with other MAT programs are still in progress.