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Cited by 3Health Policy Implementation ScienceHIV, Drug Use, Sexual RiskOpioid Use Disorder Treatment

Complexity of implementing harm reduction services in community hospitals: A two-phase qualitative study

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Nimsakul, Kanittha, Suwannaprom, Puckwipa, Suttajit, Siritree·2022·The Thai Journal of Pharmaceutical Sciences
DOI 10.56808/3027-7922.2631
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Abstract

Objective: Regardless of effective harm reduction services (HRS) in Thanyarak Hospital, difficulties exist while implementing them in community hospitals. This study aimed to investigate the complexities of HRS implementation in two community hospitals in Mae Hong Son. Methods: Phase 1, in-depth interviews were conducted with 21 participants to investigate the complexity of HRS dissemination. An interview guide was developed from the seven domains of the Non-adoption, Abandonment, Scale-up, Spread, and Sustainability framework, and thematic analysis was used. Phase 2 involved two rounds of a Delphi technique with 17 experts to evaluate the HRS’s complexity level (complex, complicated, simple). Results: Although patients were highly satisfied with HRS, implementing it in community hospitals was complex. Complex issues included: complexity in opioid addiction caused by a variety of factors; understanding social contexts and cooperating of communities and agencies outside required health sectors; and emerging of unintended consequences. Complicated issues included resources and specialized knowledge required; concerns of staff’s competencies and readiness in re-arranging regular services for HRS. Conclusion: The HRS operators should understand that they are working on complex issues. Engaging a broader system and preparing for unexpected events will boost the likelihood of success in the transfer of HRS to other settings.

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Cited by

Sorted by citations

Authors
Nimsakul, K., Suwannaprom, P., & Suttajit, S.
Affiliations
Chiang Mai University (TH)
ORCID
Venue
The Thai Journal of Pharmaceutical Sciences
Publisher
Office of Academic Resources, Chulalongkorn University - DIGITAL COMMONS JOURNALS
Published
2022-08-01
Volume
46
Issue
4
Pages
470-480
ISSN
3027-7922 (ISSN-L)
DOI
10.56808/3027-7922.2631
OpenAlex
W6950759259
Cited by
0
References
0
FWCI
0.00
Type
journal article
Language
en
Open access
Locations
The Thai Journal of Pharmaceutical Sciences (publishedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Keywords
harm reduction services, community hospitals, implementation complexity, opioid use disorder, employee skills, social environment, community participation, unintended consequences, Mae Hong Son

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