Table 2.

Interview 1 Themes

Recommendation	n	Representative Quotes
Ensure CC is trained in patient engagement	10	My doctor is so great that I can’t wait to talk to him and hear his voice. We have almost like a friendship. A care manager should be (like that). (P8) (My doctors) relate, understand, and provide guidance when I have problems. My doctor tells me, “Do this or do that, and if anything happens, please call us”… That gives me a positive reinforcement that if I have a problem, my doctor will help me. (P11) My main problem with therapy is feeling like it’s okay to talk to somebody without feeling judged. Am I going to be able to walk out of this appointment and feel like it’s not going to be all over town or they’re going to tell somebody? Are they going to get it? Because there are people out there that aren’t going to get it. It’s the trust that’s the main thing. And being judged. (P1) It seemed like the people there, especially at AA, the people thought that if you took any medications you weren’t in true recovery. I didn’t like that. That’s the way they feel. At NA, I just never could feel like I was important enough to talk. (P2)
Address socioeconomic barriers	5	Suboxone can be very expensive. I pay 150 dollars a month, so it is cheaper to go with pain pills. (P6) I had to quit counseling because my insurance got cut off. (P6)
Provide support for managing prescriptions	7	I do worry when I’m running low on my Suboxone. My prescription has to go into [nearby town], and I worry they’re not going to have it at that point or I’m going to be running late with filling it. How am I going to deal with being late if they don’t have it ready in time? (P1)
Taper frequency of CC visits over time or as needed	6	Yeah I think that once a week would be ok for the first couple months if they’re showing progress…then go longer. (P2) Whenever we need them – maybe keep in touch every 2 weeks? (P5)
Check-in with patients about possible relapse triggers	7	People who do drugs, they are doing it for a reason, they want to get away from reality. The care manager should explore those underlying reasons and the root of the problems… Missing the high and craving is a thing, also the lifestyle, including friends. (P11) They should check on how are we’re doing emotionally; emotions have to do a lot with opioid use. Also, keeping patients busy is important. [You] want to know that someone genuinely cares about you, and sometimes strangers can do a better job than family members. (P7)

Note: CC = care coordinator; P = patient.