“You’re Always Jumping Through Hoops”: Journey Mapping the Care Experiences of Individuals With Opioid Use Disorder-associated Endocarditis
Open accessAbstract
Objectives: Serious infectious complications of opioid use disorder (OUD), and specifically endocarditis, are becoming more common in the US. Individuals with OUD-associated endocarditis require long periods of complex medical care, often face recurrent addiction- and infection-related complications, and have dismal clinical outcomes. The objective of this study was to perform journey mapping analysis to capture common trajectories and patterns of care for people with OUD-associated endocarditis. Methods: This was an analysis of qualitative semi-structured interviews of individuals who received care for OUD-associated endocarditis. Interviews were conducted among individuals receiving care at a single academic healthcare system in Boston, Massachusetts. Ten participants meeting DSM-5 criteria for at least mild OUD and a culture-positive diagnosis of endocarditis who had previously completed care for OUD-associated endocarditis were recruited from inpatient and ambulatory settings. Details of participant's care episodes were extracted and visualized in an iterative journey mapping process. A grounded theory approach was then used to identify shared themes and care patterns among participants’ journey maps. Results: Common patterns of care included early addiction treatment and intensive outpatient care preceding periods without rehospitalization, while leaving outpatient care and return to drug use often directly preceded rehospitalization. Participants frequently left care by choice and proactively reengaged with care. Conclusions: Journey mapping is a novel, patient-centered approach to capturing the care experiences and trajectories of a patient population experiencing significant stigma, who engage with the healthcare system in unexpected and fragmented ways. For individuals with OUD-associated endocarditis, we identified critical moments to support and engage patients to prevent return to drug use and rehospitalization.
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Following inductive content analysis, data presented in journey maps highlight common themes and systematic barriers to include in an initial map, which is then used to obtain additional cross validation and feedback for revision.
“Following inductive content analysis, data presented in journey maps highlight common themes and systematic barriers to include in an initial map, which is then used to obtain additional cross validation and feedback for revision (Bearnot & Mitton, 2020; Vears & Gillam, 2022).”
From Experiences of Child and Adolescent Psychiatric Patients Boarding in the Emergency Department from Staff Perspectives: Patient Journey Mapping (2023) · cites this paper as Bearnot & Mitton, 2020
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- Authors
- Bearnot, B., & Mitton, J. A.
- Affiliations
- Harvard University (US)
- Corresponding author
- Bearnot, Benjamin
- ORCID
- Bearnot, Benjamin
- Venue
- Journal of Addiction Medicine
- Published
- 2020-03-05
- Volume
- 14
- Issue
- 6
- Pages
- 494-501
- ISSN
- 1932-0620 (ISSN-L)
- 1935-3227
- PMC
- PMC7483139
- OpenAlex
- W3010252432
- Cited by
- 33
- References
- 24
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 3 · 2023: 6 · 2022: 5 · 2021: 5 · 2020: 4
- FWCI
- 3.58
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Addiction Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (K12DA043490)
- Topics
- Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- opioid use disorder, infective endocarditis, journey mapping, care pathways, patient care experience, hospital readmission, addiction treatment, outpatient care, stigma, patient engagement, care fragmentation
- MeSH terms
- Boston, Endocarditis, Humans, Massachusetts, Opioid-Related Disorders, Social Stigma
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