TY - JOUR
KW - Attitude of Health Personnel
KW - Buprenorphine/therapeutic use
KW - Drug Prescriptions
KW - Humans
KW - Narcotic Antagonists/therapeutic use
KW - Physicians, Primary Care/psychology/statistics & numerical data
KW - Attitudes
KW - barriers
KW - buprenorphine
KW - primary care providers
KW - Stigma
AU - D. L. Louie
AU - M. T. Assefa
AU - M. P. McGovern
A1 - 
AB - BACKGROUND: The opioid epidemic is a major public health issue associated with significant overdose deaths. Effective treatments exist, such as the medication buprenorphine, but are not widely available. This narrative review examines the attitudes of primary care providers (PCPs) toward prescribing buprenorphine. METHODS: Narrative review of 20 articles published after the year 2000, using the Consolidated Framework for Implementation Research (CFIR) to organize the findings. RESULTS: Three of the five CFIR domains ("Intervention Characteristics," "Outer Setting," "Inner Setting") were strongly represented in our analysis. Providers were concerned about the clientele associated with buprenorphine, diversion, and their self-efficacy in prescribing the medication. Some believed that buprenorphine does not belong in the discipline of primary care. Other barriers included philosophical objections and stigma toward substance use disorders. Notably, two studies reported a shift in attitudes once physicians prescribed buprenorphine to actual patients. CONCLUSIONS: Negative attitudes toward buprenorphine encompassed multi-layered concerns, ranging from skepticism about the medication itself, the behaviors of patients with opioid use disorders, and beliefs regarding substance use disorders more generally. We speculate, however, that negative attitudes may be improved by tailoring support strategies that address providers' self-efficacy and level of knowledge.
AD - Stanford University, Palo Alto, CA, 94304, USA. dxlouie@stanford.edu.; Stanford University, Palo Alto, CA, 94304, USA.; Stanford University, Palo Alto, CA, 94304, USA.
BT - BMC family practice
C5 - Education & Workforce; Opioids & Substance Use
CP - 1
DO - 10.1186/s12875-019-1047-z
IS - 1
JF - BMC family practice
LA - eng
M1 - Journal Article
N2 - BACKGROUND: The opioid epidemic is a major public health issue associated with significant overdose deaths. Effective treatments exist, such as the medication buprenorphine, but are not widely available. This narrative review examines the attitudes of primary care providers (PCPs) toward prescribing buprenorphine. METHODS: Narrative review of 20 articles published after the year 2000, using the Consolidated Framework for Implementation Research (CFIR) to organize the findings. RESULTS: Three of the five CFIR domains ("Intervention Characteristics," "Outer Setting," "Inner Setting") were strongly represented in our analysis. Providers were concerned about the clientele associated with buprenorphine, diversion, and their self-efficacy in prescribing the medication. Some believed that buprenorphine does not belong in the discipline of primary care. Other barriers included philosophical objections and stigma toward substance use disorders. Notably, two studies reported a shift in attitudes once physicians prescribed buprenorphine to actual patients. CONCLUSIONS: Negative attitudes toward buprenorphine encompassed multi-layered concerns, ranging from skepticism about the medication itself, the behaviors of patients with opioid use disorders, and beliefs regarding substance use disorders more generally. We speculate, however, that negative attitudes may be improved by tailoring support strategies that address providers' self-efficacy and level of knowledge.
PY - 2019
SN - 1471-2296; 1471-2296
SP - 019
EP - z
EP - 157+
T1 - Attitudes of primary care physicians toward prescribing buprenorphine: a narrative review
T2 - BMC family practice
TI - Attitudes of primary care physicians toward prescribing buprenorphine: a narrative review
U1 - Education & Workforce; Opioids & Substance Use
U2 - 31729957
U3 - 10.1186/s12875-019-1047-z
VL - 20
VO - 1471-2296; 1471-2296
Y1 - 2019
Y2 - Nov 15
ER -