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Impact of Policy Change on Access to Medication for Opioid Use Disorder in Primary Care
The opioid overdose epidemic is escalating. Increasing access to medications for opioid use disorder in primary care is crucial. The impact of the US Department of Health and Human Services’ policy change removing the buprenorphine waiver training requirement on primary care buprenorphine prescribin...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10045971/ https://www.ncbi.nlm.nih.gov/pubmed/37011580 http://dx.doi.org/10.14423/SMJ.0000000000001544 |
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author | Krupp, Joanna Hung, Frances LaChapelle, Tina Yarrington, Michael E. Link, Katherine Choi, Yujung Chen, Hillary Marais, Andrea Des Sachdeva, Nidhi Chakraborty, Hrishikesh McKellar, Mehri S. |
author_facet | Krupp, Joanna Hung, Frances LaChapelle, Tina Yarrington, Michael E. Link, Katherine Choi, Yujung Chen, Hillary Marais, Andrea Des Sachdeva, Nidhi Chakraborty, Hrishikesh McKellar, Mehri S. |
author_sort | Krupp, Joanna |
collection | PubMed |
description | The opioid overdose epidemic is escalating. Increasing access to medications for opioid use disorder in primary care is crucial. The impact of the US Department of Health and Human Services’ policy change removing the buprenorphine waiver training requirement on primary care buprenorphine prescribing remains unclear. We aimed to investigate the impact of the policy change on primary care providers’ likelihood of applying for a waiver and the current attitudes, practices, and barriers to buprenorphine prescribing in primary care. METHODS: We used a cross-sectional survey with embedded educational resources disseminated to primary care providers in a southern US academic health system. We used descriptive statistics to aggregate survey data, logistic regression models to evaluate whether buprenorphine interest and familiarity correlate with clinical characteristics, and a χ(2) test to evaluate the effect of the educational intervention on screening. RESULTS: Of the 54 respondents, 70.4% reported seeing patients with opioid use disorder, but only 11.1% had a waiver to prescribe buprenorphine. Few nonwaivered providers were interested in prescribing, but perceiving buprenorphine to be beneficial to the patient population was associated with interest (adjusted odds ratio 34.7, P < 0.001). Two-thirds of nonwaivered respondents reported the policy change having no impact on their decision to obtain a waiver; however, among interested providers, it increased their likelihood of obtaining a waiver. Barriers to buprenorphine prescribing included lack of clinical experience, clinical capacity, and referral resources. Screening for opioid use disorder did not increase significantly after the survey. CONCLUSIONS: Although most primary care providers reported seeing patients with opioid use disorder, interest in prescribing buprenorphine was low and structural barriers remained the dominant obstacles. Providers with a preexisting interest in buprenorphine prescribing reported that removing the training requirement was helpful. |
format | Online Article Text |
id | pubmed-10045971 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-100459712023-03-31 Impact of Policy Change on Access to Medication for Opioid Use Disorder in Primary Care Krupp, Joanna Hung, Frances LaChapelle, Tina Yarrington, Michael E. Link, Katherine Choi, Yujung Chen, Hillary Marais, Andrea Des Sachdeva, Nidhi Chakraborty, Hrishikesh McKellar, Mehri S. South Med J Medicine & Medical Specialties The opioid overdose epidemic is escalating. Increasing access to medications for opioid use disorder in primary care is crucial. The impact of the US Department of Health and Human Services’ policy change removing the buprenorphine waiver training requirement on primary care buprenorphine prescribing remains unclear. We aimed to investigate the impact of the policy change on primary care providers’ likelihood of applying for a waiver and the current attitudes, practices, and barriers to buprenorphine prescribing in primary care. METHODS: We used a cross-sectional survey with embedded educational resources disseminated to primary care providers in a southern US academic health system. We used descriptive statistics to aggregate survey data, logistic regression models to evaluate whether buprenorphine interest and familiarity correlate with clinical characteristics, and a χ(2) test to evaluate the effect of the educational intervention on screening. RESULTS: Of the 54 respondents, 70.4% reported seeing patients with opioid use disorder, but only 11.1% had a waiver to prescribe buprenorphine. Few nonwaivered providers were interested in prescribing, but perceiving buprenorphine to be beneficial to the patient population was associated with interest (adjusted odds ratio 34.7, P < 0.001). Two-thirds of nonwaivered respondents reported the policy change having no impact on their decision to obtain a waiver; however, among interested providers, it increased their likelihood of obtaining a waiver. Barriers to buprenorphine prescribing included lack of clinical experience, clinical capacity, and referral resources. Screening for opioid use disorder did not increase significantly after the survey. CONCLUSIONS: Although most primary care providers reported seeing patients with opioid use disorder, interest in prescribing buprenorphine was low and structural barriers remained the dominant obstacles. Providers with a preexisting interest in buprenorphine prescribing reported that removing the training requirement was helpful. Lippincott Williams & Wilkins 2023-04 2023-04-03 /pmc/articles/PMC10045971/ /pubmed/37011580 http://dx.doi.org/10.14423/SMJ.0000000000001544 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Southern Medical Association. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Medicine & Medical Specialties Krupp, Joanna Hung, Frances LaChapelle, Tina Yarrington, Michael E. Link, Katherine Choi, Yujung Chen, Hillary Marais, Andrea Des Sachdeva, Nidhi Chakraborty, Hrishikesh McKellar, Mehri S. Impact of Policy Change on Access to Medication for Opioid Use Disorder in Primary Care |
title | Impact of Policy Change on Access to Medication for Opioid Use Disorder in Primary Care |
title_full | Impact of Policy Change on Access to Medication for Opioid Use Disorder in Primary Care |
title_fullStr | Impact of Policy Change on Access to Medication for Opioid Use Disorder in Primary Care |
title_full_unstemmed | Impact of Policy Change on Access to Medication for Opioid Use Disorder in Primary Care |
title_short | Impact of Policy Change on Access to Medication for Opioid Use Disorder in Primary Care |
title_sort | impact of policy change on access to medication for opioid use disorder in primary care |
topic | Medicine & Medical Specialties |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10045971/ https://www.ncbi.nlm.nih.gov/pubmed/37011580 http://dx.doi.org/10.14423/SMJ.0000000000001544 |
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