Patient and Provider Demand for and Readiness to Adopt Medications for Stimulant Use Disorders in Real-World Settings: Pre-Planning Toward Accelerated Implementation.

INTRODUCTION: In the United States, rates of stimulant use disorder (StUD) have increased over the last 20 years, yet fewer than one-third of adults receive treatment. Recent research has shown the efficacy of medication for StUD, but little is known regarding demand and readiness to adopt such treatments. This study examined patient and provider perspectives on medication for StUD in real-world practice settings. METHODS: Semi-structured interviews were conducted with patients with substance use disorder (SUD) history (n = 20) and SUD care team members (n = 20) currently providing SUD services. Interviews elicited perceptions of treatment demand, barriers/facilitators, and recommendations for future implementation. Rapid qualitative analysis was used to distill and compare findings across groups. Analysis was guided by the Health Equity Implementation Framework (HEIF), selected for its focus on implementation and social determinants. RESULTS: Consistent with HEIF, multilevel patient and care team barriers and facilitators were identified, reflecting the importance of the clinical encounter and highlighting implementation challenges within the inner, outer and societal contexts, particularly related to stigma. Training for providers and education for patients and families were recommended to overcome stigma. Utilising patient-centred care approaches and addressing societal factors impacting treatment engagement were also discussed as likely to affect medication access. DISCUSSION AND CONCLUSIONS: Examining patient and care teams' perceptions of medications for StUD improves understanding of demand and readiness for adoption. This information, rooted in lived experiences, provides a foundation for selecting tailored implementation strategies that may assist in accelerating the adoption of medications to treat StUD in future scale-up and spread.