Primary health care delivered with understanding and compassion for people who use drugs is the focus of a new Greater Victoria patient-oriented research study funded by the Canadian Institutes of Health Research

Building on a previous study that examined cultural safety for hospitalized patients who use illicit drugs, a research team will now study how this population experiences barriers to primary care. Health researchers from the University of Victoria’s Centre for Addictions Research of BC (CARBC) and Royal Roads University are partnering with a diverse team that includes community partners Society of Living Illicit Drug Users (SOLID) and the Umbrella Society, as well as the Victoria Division of Family Practice and Island Health.

Patient-oriented research offers a tremendous opportunity to engage with the community in shaping projects that will have a vital and immediate impact. This type of research partnership aligns strongly with UVic’s commitment to community-engaged research. By working together, the university and local partners can identify research priorities and co-develop research projects, promote knowledge mobilization, improve health outcomes and benefit society. — David Castle, University of Victoria vice-president of research

Trying to seek health care from providers who can’t see past assumptions

Patient-oriented research engages patient partners from the onset—from identifying which issues to research,
what questions to ask, who to ask them of, and how best to put results into practice more quickly to improve health care.

One of the SOLID researchers participating in the study, Jill, says her reasons for involvement go well beyond just wanting to share her own anecdotes of trying to seek health care from providers who couldn’t see past their assumptions about substance use.

“It was about sharing my story so that it could inform and educate,” she says. “We all know that research drives quality, quality means better care, and better care means healthier outcomes for patients in my situation. Patient-oriented research is research that fully engages us as partners.”

We are excited to be a part of this dynamic collaboration, where the priorities of the research and its conduct are driven by people who have lived experience. This project has the potential to shape research and improve the health of people who use drugs across Canada. — Cindy Trytten, Island Health director of research capacity-building

Raising awareness among physicians

“Part of the project’s role is to increase the awareness of the experience of people,
to help primary care physicians understand what it’s actually like to try to seek health care
for this group of people,” says researcher Karen Urbanoski.

Having physicians alongside people who use drugs around the same research planning table has already been invaluable in raising awareness, notes Karen Urbanoski, a Canada Research Chair in Substance Use, Addictions and Health Services Research and scientist with CARBC.

“Part of the project’s role is to increase the awareness of the experience of people, to help primary care physicians understand what it’s actually like to try to seek health care for this group of people,” says Urbanoski. “It’s really challenging for people, whether they are drug users or face other disadvantages: Poverty, homelessness, violence, racism, colonialism. We see this work as the kind of thing that can be turned into training, and that will come up with a model for safe primary care.”

The “system just doesn’t work” for some people trying to survive day to day

The research project is seen as a vital initiative at a time when overdose deaths
in BC are claiming the lives of as many as four people a day.

Bernie Pauly—a professor in UVic’s School of Nursing, a researcher with UVic’s Centre for Addictions Research of BC, and Island Health’s Scholar-in-Residence—has done research work with SOLID for 10 years, and sees the project as a vital initiative at a time when overdose deaths in BC are claiming the lives of as many as four people a day. “I don’t think primary care serves this population well,” says Pauly. “When you’re a person trying to survive day to day, the system just doesn’t work.”

This study is the first patient-oriented research study supported by the BC SUPPORT Vancouver Island Regional Centre, a collaboration between UVic and Island Health, one of four regional centres in the province. The SUPPORT Unit (BC Support for People and Patient-Oriented Research and Trials Unit) is funded through a $40-million grant from CIHR with $40 million in matching grants and in-kind contributions from academic institutions, health authorities and other community partners.

The BC SUPPORT Unit aims to foster patient-oriented research by engaging people with lived experience, which includes family members and caregivers, as research partners to guide every aspect of a study. Patient-oriented research engages patient partners from the onset—from identifying which issues to research, what questions to ask, who to ask them of, and how best to put results into practice more quickly to improve health care. It also builds multi-disciplinary teams that bring together people who provide health care, researchers and those who make decisions about health care services.

We speak with Karen Urbanoski, a scientist with the Centre for Addictions Research of B.C.

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— People First Radio (@peoplefirstrad) June 14, 2017