“It could bring a lot of help to people that aren’t getting help right now”: A qualitative analysis of the impact of virtual care on access to primary care for people with opioid use disorder

Primary care plays a vital role for people with opioid use disorder and the COVID-19 pandemic introduced new challenges for this population to access primary care. While the expansion of virtual care was intended to support access to essential primary care, little is known about how this has affected the ability of people with opioid use disorder to access the full range of primary care services. Our objective is to explore the experiences of family physicians and people with opioid use disorder to understand how virtual care has impacted primary care access for people with opioid use disorder in British Columbia, Canada. We conducted semi-structured interviews with people with opioid use disorder and licensed family physicians who provide care to this population. Interviews were recorded, transcribed, and thematically analyzed. We present participants' experiences by the six dimensions of access: availability, accessibility, accommodation, affordability, acceptability, and awareness. Virtual visits were perceived by participants as a valuable option for accessing primary care needs, in addition to opioid use disorder management. These data describe how tailoring virtual care to the complex and intersecting needs of people with opioid use disorder can help promote equitable access to primary care. Our findings highlight the varied dimensions of access that influence virtual care experiences for people with opioid use disorder and their primary care providers. As virtual care becomes a routine primary care modality, ensuring equitable access will require attention to each dimension.