TY - JOUR
KW - Analgesics, Opioid/adverse effects
KW - Buprenorphine, Naloxone Drug Combination/administration & dosage
KW - Humans
KW - Methadone/administration & dosage
KW - Opiate Substitution Treatment
KW - Opioid-Related Disorders/drug therapy
KW - Physicians, Family
KW - Practice Patterns, Physicians'/statistics & numerical data
KW - Primary Health Care/statistics & numerical data
KW - Barrier
KW - Buprenorphine-suboxone
KW - Facilitator
KW - Family physician
KW - Methadone
KW - opiate addiction
KW - opioid agonist therapy
KW - opioid use disorder
KW - Prescribing
KW - primary care
AU - L. L. Nixon
AU - J. C. Marlinga
AU - K. A. Hayden
AU - K. J. Mrklas
A1 - 
AB - BACKGROUND: Opiate agonist therapy (OAT) prescribing rates by family physicians are low in the context of community-based, comprehensive primary care. Understanding the factors that support and/or inhibit OAT prescribing within primary care is needed. Our study objectives are to identify and synthesize documented barriers to, and facilitators of, primary care opioid agonist prescribing, and effective strategies to inform intervention planning and support increased primary care OAT prescribing. METHODS/DESIGN: We will systematically search EMBASE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, MEDLINE, and gray literature in three domains: primary care providers, opioid agonist therapy, and opioid abuse. We will retain and assess primary studies reporting documented participation, or self-reported willingness to participate, in OAT prescribing; and/or at least one determinant of OAT prescribing; and/or strategies to address determinants of OAT prescribing from the perspective of primary care providers in comprehensive, community-based practice settings. There will be no restrictions on study design or publication date. Studies limited to specialty clinics with specialist prescribers, lacking extractable data, or in languages other than English or French will be excluded. Two reviewers will perform abstract review and data extraction independently. We will assess the quality of included studies using the Joanna Briggs Institute Critical Appraisal Tool. We will use a framework method of analysis to deductively code barriers and facilitators and to characterize effective strategies to support prescribing using a combined, modified a priori framework comprising the Theoretical Domains Framework and the Consolidated Framework for Implementation Research. DISCUSSION: To date, no synthesis has been undertaken of the barriers and facilitators or effective interventions promoting OAT prescribing by primary care clinicians in community-based comprehensive care settings. Enacting change in physician behaviors, community-based programming, and health services is complex and best informed by using theoretical frameworks that allow the analysis of the available data to assist in designing and implementing interventions. In light of the current opioid crisis, increasing the capacity of primary care clinicians to provide OAT is an important strategy to curb morbidity and mortality from opioid use disorder. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD86835.
AD - Department of Family Medicine, Cumming School of Medicine, University of Calgary, Room G012 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada. lnixon@ucalgary.ca.; Department of Family Medicine, Cumming School of Medicine, University of Calgary, Room G012 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.; Libraries & Cultural Resources, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 4N1, Canada.; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.; Strategic Clinical Networks™, System Innovation and Programs, Alberta Health Services, 403 - 29th Street NW, Calgary, AB, T2N 2T9, Canada.
BT - Systematic reviews
C5 - Education & Workforce; Opioids & Substance Use
CP - 1
DO - 10.1186/s13643-019-1076-7
IS - 1
JF - Systematic reviews
LA - eng
M1 - Journal Article
N2 - BACKGROUND: Opiate agonist therapy (OAT) prescribing rates by family physicians are low in the context of community-based, comprehensive primary care. Understanding the factors that support and/or inhibit OAT prescribing within primary care is needed. Our study objectives are to identify and synthesize documented barriers to, and facilitators of, primary care opioid agonist prescribing, and effective strategies to inform intervention planning and support increased primary care OAT prescribing. METHODS/DESIGN: We will systematically search EMBASE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, MEDLINE, and gray literature in three domains: primary care providers, opioid agonist therapy, and opioid abuse. We will retain and assess primary studies reporting documented participation, or self-reported willingness to participate, in OAT prescribing; and/or at least one determinant of OAT prescribing; and/or strategies to address determinants of OAT prescribing from the perspective of primary care providers in comprehensive, community-based practice settings. There will be no restrictions on study design or publication date. Studies limited to specialty clinics with specialist prescribers, lacking extractable data, or in languages other than English or French will be excluded. Two reviewers will perform abstract review and data extraction independently. We will assess the quality of included studies using the Joanna Briggs Institute Critical Appraisal Tool. We will use a framework method of analysis to deductively code barriers and facilitators and to characterize effective strategies to support prescribing using a combined, modified a priori framework comprising the Theoretical Domains Framework and the Consolidated Framework for Implementation Research. DISCUSSION: To date, no synthesis has been undertaken of the barriers and facilitators or effective interventions promoting OAT prescribing by primary care clinicians in community-based comprehensive care settings. Enacting change in physician behaviors, community-based programming, and health services is complex and best informed by using theoretical frameworks that allow the analysis of the available data to assist in designing and implementing interventions. In light of the current opioid crisis, increasing the capacity of primary care clinicians to provide OAT is an important strategy to curb morbidity and mortality from opioid use disorder. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD86835.
PY - 2019
SN - 2046-4053; 2046-4053
SP - 019
EP - 7
EP - 186+
T1 - Barriers and facilitators to office-based opioid agonist therapy prescribing and effective interventions to increase provider prescribing: protocol for a systematic review
T2 - Systematic reviews
TI - Barriers and facilitators to office-based opioid agonist therapy prescribing and effective interventions to increase provider prescribing: protocol for a systematic review
U1 - Education & Workforce; Opioids & Substance Use
U2 - 31345258
U3 - 10.1186/s13643-019-1076-7
VL - 8
VO - 2046-4053; 2046-4053
Y1 - 2019
Y2 - Jul 25
ER -