The relationship between patient-centred care for substance use disorders and patient outcomes: A scoping review.

BACKGROUND

Patient-centred care (PCC) is considered crucial for high-quality substance use disorder (SUD) treatment and care, but it is unclear whether PCC is associated with enhanced outcomes. This review aimed to map available evidence of the relationship between PCC and outcomes across the SUD treatment continuum.

METHODS

We conducted a scoping review of the literature on the relationship between PCC for SUD and service outcomes in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Six electronic databases were searched for peer-reviewed articles published in English between January 1994 and June 2024. After screening 5268 titles and abstracts and 186 full texts in duplicate, data were extracted from 135 articles and narratively synthesized according to six PCC dimensions (therapeutic alliance, shared decision-making, personalised supports, integrated care for co-occurring disorders, trauma-informed and culturally-informed care).

RESULTS

The findings from this review suggest largely positive associations between these PCC components and the outcomes of generalist and specialist SUD services. Few studies (<1 %) assessed more than one PCC dimension. The therapeutic alliance was the most frequently assessed dimension (35.6 %, 48/135 articles), followed by shared decision-making (16.3 %, 22/135 articles), trauma-informed care (14.8 %, 20/135 articles), integrated care (13.3 %, 18/135 articles), and personalised services (13.3 %, 18/135 articles). PCC in generalist services was associated with greater SUD treatment utilization and fewer adverse events. PCC in specialist SUD treatment was largely associated with better SUD outcomes.

CONCLUSIONS

This review highlighted evidence gaps on the relationship between PCC and SUD service outcomes, with literature scant for some PCC dimensions and studies typically examining a single dimension of PCC. More research is needed to understand the relative importance of each PCC dimension for predicting SUD service outcomes, how these dimensions interact to influence outcomes, and to develop and evaluate interventions for enhancing PCC.