Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

Injection heroin users are at an extremely high risk of many drug related harms such as HIV, hepatitis C and overdose death. Some are unable to stop injecting, despite the harms to them and the community. Considering the severity of the harms associated with long-term injection, it is very important that the health care system reaches this vulnerable population. While some treatments exist, they are not always successful, especially for people with the most severe cases of addiction. As a result, these people do not receive treatment and remain outside of the health care system. A Canadian study is following the only patients in North America receiving injectable treatment for chronic heroin dependence under the supervision of health care providers. Patient engagement in treatment is critical as it affects health outcomes and overall health care costs and efficiency. Studies of patients with chronic conditions such as diabetes have shown that communication between patients and health care providers is crucial to providing quality care, improving health, and helping patients to manage the complications that come along with their conditions. This suggests that patient provider communication may be a central component of care for patients with heroin addiction, and a tool to better engage these patients in health care services. This study will collect information on patient contact with treatment services (e.g. number of days of contact) on a monthly basis for 12 months. Patients representing different patterns of contact will be interviewed to explore their unique experiences communicating with providers. This will be the first study to explore the role of patient provider communication on improving the self-management of chronic heroin dependence. This evidence will bring forward areas of patient provider communication that could make a difference in improving treatment adherence for thousands of patients.