TY - JOUR
T1 - Primary care physicians’ preparedness to treat opioid use disorder in the United States
T2 - A cross-sectional survey
AU - Foti, Kathryn
AU - Heyward, James
AU - Tajanlangit, Matthew
AU - Meek, Kristin
AU - Jones, Christopher
AU - Kolodny, Andrew
AU - Alexander, G. Caleb
N1 - Funding Information:
This study was funded by a Liptiz Public Health Policy Award from the Institute for Health and Social Policy at the Johns Hopkins Bloomberg School of Public Health .
Publisher Copyright:
© 2021 Elsevier B.V.
PY - 2021/8/1
Y1 - 2021/8/1
N2 - Background: Efforts to increase opioid use disorder (OUD) treatment have focused on primary care. We assessed primary care physicians’ preparedness to identify and treat individuals with OUD and barriers to increasing buprenorphine prescribing. Methods: We conducted a cross-sectional survey from January–August 2020 which assessed perceptions of the opioid epidemic; comfort screening, diagnosing, and treating individuals with OUD with medications; and barriers to obtaining a buprenorphine waiver and prescribing buprenorphine in their practice. Primary care physicians were sampled from the American Medical Association Physician Master File (n = 1000) and contacted up to 3 times, twice by mail and once by e-mail. Results: Overall, 173 physicians (adjusted response rate 27.3 %) responded. While most were somewhat or very comfortable screening (80.7 %) and diagnosing (79.3 %) OUD, fewer (36.9 %) were somewhat or very comfortable treating OUD with medications. One third of respondents were in a practice where they or a colleague were waivered and 10.7 % of respondents had a buprenorphine waiver. The most commonly cited barriers to both obtaining a waiver and prescribing buprenorphine included lack of access to addiction, behavioral health, or psychiatric co-management, lack of experience treating OUD, preference not to be inundated with requests for buprenorphine, and the buprenorphine training requirement. Conclusions: While most primary care physicians reported comfort screening and diagnosing OUD, fewer were comfortable treating OUD with medications such as buprenorphine and even fewer were waivered to do so. Addressing provider self-efficacy and willingness, and identifying effective, coordinated, and comprehensive models of care may increase OUD treatment with buprenorphine.
AB - Background: Efforts to increase opioid use disorder (OUD) treatment have focused on primary care. We assessed primary care physicians’ preparedness to identify and treat individuals with OUD and barriers to increasing buprenorphine prescribing. Methods: We conducted a cross-sectional survey from January–August 2020 which assessed perceptions of the opioid epidemic; comfort screening, diagnosing, and treating individuals with OUD with medications; and barriers to obtaining a buprenorphine waiver and prescribing buprenorphine in their practice. Primary care physicians were sampled from the American Medical Association Physician Master File (n = 1000) and contacted up to 3 times, twice by mail and once by e-mail. Results: Overall, 173 physicians (adjusted response rate 27.3 %) responded. While most were somewhat or very comfortable screening (80.7 %) and diagnosing (79.3 %) OUD, fewer (36.9 %) were somewhat or very comfortable treating OUD with medications. One third of respondents were in a practice where they or a colleague were waivered and 10.7 % of respondents had a buprenorphine waiver. The most commonly cited barriers to both obtaining a waiver and prescribing buprenorphine included lack of access to addiction, behavioral health, or psychiatric co-management, lack of experience treating OUD, preference not to be inundated with requests for buprenorphine, and the buprenorphine training requirement. Conclusions: While most primary care physicians reported comfort screening and diagnosing OUD, fewer were comfortable treating OUD with medications such as buprenorphine and even fewer were waivered to do so. Addressing provider self-efficacy and willingness, and identifying effective, coordinated, and comprehensive models of care may increase OUD treatment with buprenorphine.
KW - Buprenorphine
KW - Opioid use disorder
KW - Primary care
KW - Treatment
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U2 - 10.1016/j.drugalcdep.2021.108811
DO - 10.1016/j.drugalcdep.2021.108811
M3 - Article
C2 - 34175786
AN - SCOPUS:85108618835
SN - 0376-8716
VL - 225
JO - Drug and alcohol dependence
JF - Drug and alcohol dependence
M1 - 108811
ER -