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Trust in Hospital Physicians Among Patients With Substance Use Disorder Referred to an Addiction Consult Service: A Mixed-methods Study.
J Addict Med. 2022 Jan-Feb 01; 16(1):41-48.JA

Abstract

BACKGROUND

Trust is essential in patient-physician relationships. Hospitalized patients with substance use disorders (SUDs) often experience stigma and trauma in the hospital, which can impede trust. Little research has explored the role of hospital-based addictions care in creating trusting relationships with patients with SUDs. This study describes how trust in physicians changed among hospitalized people with SUDs who were seen by an interprofessional addiction medicine service.

METHODS

We analyzed data from hospitalized patients with SUD seen by an addiction consult service from 2015 to 2018. Participants completed surveys at baseline and 30 to 90 days after hospital discharge. Follow-up assessments included open-ended questions exploring participant experiences with hospitalization and the addiction consult service. We measured provider trust using the Wake Forest Trust scale. We modeled trust trajectories using discrete mixture modeling, and sampled qualitative interviews from those trust trajectories.

RESULTS

Of 328 participants with SUD who had prior hospitalizations but had not previously been seen by an addiction consult service, 196 (59.8%) had both baseline and follow-up trust scores. We identified 3 groups of patients: Persistent-Low Trust, Increasing Trust, and Persistent-High Trust and 4 qualitative themes around in-hospital trust: humanizing care, demonstrating addiction expertise, reliability, and granting agency.

CONCLUSIONS

Most participants retained or increased to high trust levels after hospitalization with an addiction consult service. Addiction consult services can create environments where healthcare providers build trust with, and humanize care for, hospitalized patients with SUD, and can also mitigate power struggles that hospitalized patients with SUD frequently experience.

Links

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Authors+Show Affiliations

King C
Department of Biomedical Engineering, School of Medicine, Oregon Health and Science University, Portland, OR (CK), MD/PhD Program, School of Medicine, Oregon Health and Science University, Portland, OR (CK), Department of Sociology, University of Washington, Seattle, WA (DC), Department of Medicine, Oregon Health and Science University, Portland, OR (AP, CN, HE), School of Social Work, Portland State University, Portland, OR (CN).
Collins D
No affiliation info available
Patten A
No affiliation info available
Nicolaidis C
No affiliation info available
Englander H
No affiliation info available

MeSH

HospitalsHumansPhysiciansReproducibility of ResultsSubstance-Related DisordersTrust

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33577229

Citation

King, Caroline, et al. "Trust in Hospital Physicians Among Patients With Substance Use Disorder Referred to an Addiction Consult Service: a Mixed-methods Study." Journal of Addiction Medicine, vol. 16, no. 1, 2022, pp. 41-48.
King C, Collins D, Patten A, et al. Trust in Hospital Physicians Among Patients With Substance Use Disorder Referred to an Addiction Consult Service: A Mixed-methods Study. J Addict Med. 2022;16(1):41-48.
King, C., Collins, D., Patten, A., Nicolaidis, C., & Englander, H. (2022). Trust in Hospital Physicians Among Patients With Substance Use Disorder Referred to an Addiction Consult Service: A Mixed-methods Study. Journal of Addiction Medicine, 16(1), 41-48. https://doi.org/10.1097/ADM.0000000000000819
King C, et al. Trust in Hospital Physicians Among Patients With Substance Use Disorder Referred to an Addiction Consult Service: a Mixed-methods Study. J Addict Med. 2022 Jan-Feb 01;16(1):41-48. PubMed PMID: 33577229.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trust in Hospital Physicians Among Patients With Substance Use Disorder Referred to an Addiction Consult Service: A Mixed-methods Study. AU - King,Caroline, AU - Collins,Devin, AU - Patten,Alisa, AU - Nicolaidis,Christina, AU - Englander,Honora, PY - 2021/2/13/pubmed PY - 2022/3/19/medline PY - 2021/2/12/entrez SP - 41 EP - 48 JF - Journal of addiction medicine JO - J Addict Med VL - 16 IS - 1 N2 - BACKGROUND: Trust is essential in patient-physician relationships. Hospitalized patients with substance use disorders (SUDs) often experience stigma and trauma in the hospital, which can impede trust. Little research has explored the role of hospital-based addictions care in creating trusting relationships with patients with SUDs. This study describes how trust in physicians changed among hospitalized people with SUDs who were seen by an interprofessional addiction medicine service. METHODS: We analyzed data from hospitalized patients with SUD seen by an addiction consult service from 2015 to 2018. Participants completed surveys at baseline and 30 to 90 days after hospital discharge. Follow-up assessments included open-ended questions exploring participant experiences with hospitalization and the addiction consult service. We measured provider trust using the Wake Forest Trust scale. We modeled trust trajectories using discrete mixture modeling, and sampled qualitative interviews from those trust trajectories. RESULTS: Of 328 participants with SUD who had prior hospitalizations but had not previously been seen by an addiction consult service, 196 (59.8%) had both baseline and follow-up trust scores. We identified 3 groups of patients: Persistent-Low Trust, Increasing Trust, and Persistent-High Trust and 4 qualitative themes around in-hospital trust: humanizing care, demonstrating addiction expertise, reliability, and granting agency. CONCLUSIONS: Most participants retained or increased to high trust levels after hospitalization with an addiction consult service. Addiction consult services can create environments where healthcare providers build trust with, and humanize care for, hospitalized patients with SUD, and can also mitigate power struggles that hospitalized patients with SUD frequently experience. SN - 1935-3227 UR - https://www.unboundmedicine.com/medline/citation/33577229/Trust_in_Hospital_Physicians_Among_Patients_With_Substance_Use_Disorder_Referred_to_an_Addiction_Consult_Service:_A_Mixed_methods_Study_ DB - PRIME DP - Unbound Medicine ER -