{
  "abstract": "Question What are the values and preferences of safer opioid supply clients?Study selection and analysis We conducted a systematic review of qualitative studies on safer opioid supply client experiences published between January 2016 and August 2024. Searches were conducted across seven databases—MEDLINE, Embase, PsycINFO, CINAHL, EBM Reviews, Web of Science and Scopus—and supplemented with searches in Google Scholar and relevant repositories. Study quality was assessed using the Critical Appraisal Skills Programme. Data analysis was guided by Thomas and Harden’s thematic synthesis approach and confidence in review findings was evaluated using Grading of Recommendations Assessment, Development and Evaluation–Confidence in the Evidence from Reviews of Qualitative research. The review was registered with PROSPERO (CRD42022384447).Findings Our thematic synthesis included 19 peer-reviewed original research articles involving 459 study participants from British Columbia and Ontario, of whom 60.1% were men and 36.1% were women. Our findings centred on four cross-cutting analytic themes: (1) client-relevant goals and outcomes (withdrawal management, pain management, socioeconomic improvements), (2) the right medications to optimise client-relevant outcomes (multiple medication and formulation options, flexible dosage), (3) supportive, client-centred care environment (safe, welcoming and non-judgmental spaces, coordinating access to health and social support services, shared decision-making) and (4) complex adaptive systems approach to clinical policies (understanding the complexity of clients’ living circumstances, flexible dose schedules, non-punitive policies). Confidence in findings ranged from moderate to high.Conclusions Safer opioid supply’s success depends on providing individualised opioid medications, fostering person-centred care and implementing adaptive clinical policies. A supportive and flexible model enhances client satisfaction, sustains programme participation and optimises client-relevant outcomes.",
  "authors": [
    {
      "affiliations": [
        "Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada",
        "Centre on Drug Policy Evaluation, MAP Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Ontario, Canada",
        "Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"
      ],
      "name": "Frishta Nafeh"
    },
    {
      "affiliations": [
        "Centre on Drug Policy Evaluation, MAP Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Ontario, Canada"
      ],
      "name": "Lucas Martignetti"
    },
    {
      "affiliations": [
        "Faculty of Medicine, Memorial University, St. John’s, Newfoundland and Labrador, Canada"
      ],
      "name": "Gillian Kolla"
    },
    {
      "affiliations": [
        "Changemark Research & Evaluation, Vancouver, British Columbia, Canada"
      ],
      "name": "Matthew Bonn"
    },
    {
      "affiliations": [
        "Centre on Drug Policy Evaluation, MAP Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Ontario, Canada"
      ],
      "name": "Shahryar Moradi Falah Langeroodi"
    },
    {
      "affiliations": [
        "Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada",
        "Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada"
      ],
      "name": "Karen Urbanoski"
    },
    {
      "affiliations": [
        "Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada",
        "School of Nursing, University of Victoria, Victoria, British Columbia, Canada"
      ],
      "name": "Bernie Pauly"
    },
    {
      "affiliations": [
        "Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada",
        "Centre on Drug Policy Evaluation, MAP Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Ontario, Canada",
        "Division of Infectious Diseases and Global Public Health, University of California San Diego School of Medicine, La Jolla, California, USA"
      ],
      "name": "Dan Werb"
    },
    {
      "affiliations": [
        "Centre on Drug Policy Evaluation, MAP Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Ontario, Canada",
        "Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada",
        "HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran"
      ],
      "name": "Mohammad Karamouzian"
    }
  ],
  "title": "Safer opioid supply clients’ values and preferences: a systematic review and thematic synthesis of qualitative research",
  "uid": "40ecc8c2-b043-5c50-a944-fdeccabcc615"
}