Substance use disorder (SUD), affects more than 2 million Americans, including thousands of Veterans, and is a primary driver of >100,000 overdose deaths per year in the United States. Medication treatment for SUD reduces mortality by up to 50%, yet surprisingly few (<50% in VA4) receive it. Lack of engagement in care (i.e., seeking care, pursuing treatment, adhering to treatment plan, following up with a provider) is a major contributor to low rates of medication initiation and retention, yet why levels of engagement remain low is not well understood. However, there is evidence that low levels of patient-centered care negatively affect patients with SUD and could drive low levels of engagement.

Patient-centered care is described by the National Academy of Medicine as a core tenet of quality that is respectful of and responsive to individual patient preferences and needs and ensures patient values guide all clinical decisions. Despite its central importance, patient-centered care as a measure of quality for SUD is not well studied, which is likely attributable to the inherent difficulty in measuring patient-centered care with conventional data (e.g., chart review, patient surveys). More reliable measurement approaches could enable the incorporation of patient-centered care into quality measurement and quality improvement frameworks for SUD—all of which as the potential to increase patient engagement improve outcomes.