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    Barriers and facilitators to opioid agonist therapy in rural and remote communities in Canada: an integrative review

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    13011_2022_Article_463.pdf (1.635Mb)
    Date
    2022-08-26
    Author
    Pijl, Em M.
    Alraja, Abeer
    Duff, Elsie
    Cooke, Carol
    Dash, Stephen
    Nayak, Nichole
    Lamoureux, Jesse
    Poulin, Ginette
    Knight, Erin
    Fry, Ben
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    Abstract
    Abstract Background People living in rural and remote communities in Canada are often disproportionately impacted by opioid use disorder. When compared to urban centres, rural and remote populations face additional barriers to treatment, including geographical distance as well as chronic shortages of health care professionals. This integrative review of the literature was conducted to explore the facilitators and barriers of OAT in rural and remote Canadian communities. Methods A search of the literature identified relevant studies published between 2001 and 2021. Results The search strategy yielded 26 scholarly peer-reviewed publications, which explored specific barriers and facilitators to rural and remote OAT in Canada, along with two reports and one fact sheet from the grey literature. Most of the scholarly articles were descriptive studies (n = 14) or commentaries (n = 9); there were only three intervention studies. Facilitators and barriers to OAT programs were organized into six themes: intrapersonal/patient factors, social/non-medical program factors, family/social context factors (including community factors), infrastructure/environmental factors, health care provider factors, and system/policy factors. Conclusions Although themes in the literature resembled the social-ecological framework, most of the studies focused on the patient-provider dyad. Two of the most compelling studies focused on community factors that positively impacted OAT success and highlighted a holistic approach to care, nested in a community-based holistic model. Further research is required to foster OAT programs in rural and remote communities.
    URI
    https://doi.org/10.1186/s13011-022-00463-5
    http://hdl.handle.net/1993/36830
    Collections
    • Rady Faculty of Health Sciences Scholarly Works [1296]
    • University of Manitoba Scholarship [1981]

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