Article in Norwegian and English.
Abstract (not available on Pubmed yet):
Background. The Norwegian model for opioid maintenance treatment (OMT) «Drug-assisted rehabilitation» (DAR) is a cross-disciplinary tripartite model for the treatment of opioid dependence. The model requires collaboration among GPs, the social services and the specialist health services. To some degree it restricts the doctor’s professional autonomy. The investigation aims to examine GPs’ attitudes to the model and in particular the experiences of those who have actively participated. Material and method. An electronic questionnaire (Questback) was sent to Norwegian GPs listed on the members’ register of the Norwegian Medical Association. The respondents were questioned about their general opinions of drug-assisted rehabilitation. Those who had had relevant patients were asked about their experiences and evaluations based on 22 statements.Results. 1 165 doctors (34 % of all registered GPs) responded to the survey. 155 (13 %) were negative, 395 (34 %) neutral, and 604 (53 %) were positive towards drug-assisted rehabilitation. 683 (59 %) were doctors with DAR experience. These were treating approximately 50 % of the country’s DAR patients. The tripartite model received significant support. Very few want greater autonomy. The majority also support the strong emphasis on monitoring, although some, particularly older doctors with DAR experience, believe that urine tests could be replaced by personal contact.Interpretation. Drug-assisted rehabilitation was mainly viewed positively by Norwegian GPs in this sample. There was little opposition to the doctor’s role in the model, even though it restricts the autonomy of the individual doctor to some degree.
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Sammendrag:
Bakgrunn. Legemiddelassistert rehabilitering (LAR) er en tverrfaglig trepartsmodell for behandling av opioidavhengighet. Modellen forutsetter samhandling mellom allmennlegene, sosialtjenesten og spesialisthelsetjenesten. Den innskrenker i noen grad legenes faglige autonomi. Undersøkelsen tar sikte på å undersøke fastlegers holdninger til modellen og spesielt erfaringene til dem som har deltatt aktivt i den. Materiale og metode. Et elektronisk spørreskjema (Questback) ble sendt til norske fastleger på grunnlag av Legeforeningens medlemsregister. Respondentene ble spurt om generell oppfatning av legemiddelassistert rehabilitering. De som hadde hatt slike pasienter ble spurt om sine erfaringer og vurderinger basert på 22 utsagn. Resultater. 1 165 leger (34 %) besvarte undersøkelsen. 155 (13 %) var negative, 395 (34 %) nøytrale, og 604 (53 %) positive til legemiddelassistert rehabilitering. 683 (59 %) hadde erfaring som LAR-lege. Disse hadde ca. 50 % av landets LAR-pasienter i behandling. Trepartsmodellen har betydelig støtte. Svært få ønsker større autonomi. Majoriteten støtter også den store vekten på kontroll, selv om noen, særlig eldre leger med LAR-erfaring, mener at urinkontroller bør kunne erstattes med personlig kontakt. Fortolkning. Legemiddelassistert rehabilitering ble hovedsakelig vurdert positivt av norske fastleger i dette utvalget. Det var liten opposisjon mot legerollen i modellen, selv om den i noen grad innskrenker den enkelte leges autonomi.
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