TY - JOUR
KW - Adult
KW - Aged
KW - Buprenorphine/therapeutic use
KW - COVID-19/epidemiology
KW - Drug Prescriptions/statistics & numerical data
KW - Female
KW - Health Care Surveys
KW - Health Services Accessibility
KW - Humans
KW - Male
KW - Middle Aged
KW - Opioid-Related Disorders/drug therapy
KW - Pandemics
KW - Practice Patterns, Physicians'/legislation & jurisprudence
KW - Telemedicine
KW - United States/epidemiology
KW - buprenorphine
KW - COVID-19
KW - Medication treatment for opioid use disorder
KW - opioid overdose
KW - opioid use disorder
AU - C. M. Jones
AU - M. M. Diallo
AU - M. Vythilingam
AU - J. G. Schier
AU - M. Eisenstat
AU - W. M. Compton
A1 - 
AB - BACKGROUND: To determine how clinicians with a DATA waiver to prescribe buprenorphine for opioid use disorder (OUD) adapted during the COVID-19 pandemic to emergency authorities, including use of telehealth to prescribe buprenorphine, the challenges faced by clinicians, and strategies employed by them to manage patients with OUD. METHODS: From June 23, 2020 to August 19, 2020, we conducted an electronic survey of U.S. DATA-waivered clinicians. Descriptive statistics and multivariable logistic regression were used for analysis. RESULTS: Among 10,238 respondents, 68 % were physicians, 25 % nursing-related providers, and 6% physician assistants; 28 % reported never prescribing or not prescribing in the 12 months prior to the survey. Among the 72 % of clinicians who reported past 12-month buprenorphine prescribing (i.e. active practitioners during the pandemic) 30 % reported their practice setting closed to in-person visits during COVID-19; 33 % reported remote prescribing to new patients without an in-person examination. The strongest predictors of remote buprenorphine prescribing to new patients were prescribing buprenorphine to larger numbers of patients in an average month in the past year and closure of the practice setting during the pandemic; previous experience with remote prescribing to established patients prior to COVID-19 also was a significant predictor. Among clinicians prescribing to new patients without an in-person examination, 5.5 % reported difficulties with buprenorphine induction, most commonly withdrawal symptoms. CONCLUSIONS: Telehealth practices and prescribing to new patients without an in-person examination were adopted by DATA-waivered clinicians during the first six months of COVID-19. Permanent adoption of these authorities may enable expanded access to buprenorphine treatment.
AD - National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States. Electronic address: fjr0@cdc.gov.; National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States.; Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services, Washington, DC, United States.; National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States.; National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States.; National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States.
BT - Drug and alcohol dependence
C5 - Education & Workforce; HIT & Telehealth; Opioids & Substance Use
CY - Ireland
DO - 10.1016/j.drugalcdep.2021.108783
JF - Drug and alcohol dependence
LA - eng
M1 - Journal Article
N2 - BACKGROUND: To determine how clinicians with a DATA waiver to prescribe buprenorphine for opioid use disorder (OUD) adapted during the COVID-19 pandemic to emergency authorities, including use of telehealth to prescribe buprenorphine, the challenges faced by clinicians, and strategies employed by them to manage patients with OUD. METHODS: From June 23, 2020 to August 19, 2020, we conducted an electronic survey of U.S. DATA-waivered clinicians. Descriptive statistics and multivariable logistic regression were used for analysis. RESULTS: Among 10,238 respondents, 68 % were physicians, 25 % nursing-related providers, and 6% physician assistants; 28 % reported never prescribing or not prescribing in the 12 months prior to the survey. Among the 72 % of clinicians who reported past 12-month buprenorphine prescribing (i.e. active practitioners during the pandemic) 30 % reported their practice setting closed to in-person visits during COVID-19; 33 % reported remote prescribing to new patients without an in-person examination. The strongest predictors of remote buprenorphine prescribing to new patients were prescribing buprenorphine to larger numbers of patients in an average month in the past year and closure of the practice setting during the pandemic; previous experience with remote prescribing to established patients prior to COVID-19 also was a significant predictor. Among clinicians prescribing to new patients without an in-person examination, 5.5 % reported difficulties with buprenorphine induction, most commonly withdrawal symptoms. CONCLUSIONS: Telehealth practices and prescribing to new patients without an in-person examination were adopted by DATA-waivered clinicians during the first six months of COVID-19. Permanent adoption of these authorities may enable expanded access to buprenorphine treatment.
PP - Ireland
PY - 2021
SN - 1879-0046; 0376-8716
SP - 108783
T1 - Characteristics and correlates of U.S. clinicians prescribing buprenorphine for opioid use disorder treatment using expanded authorities during the COVID-19 pandemic
T2 - Drug and alcohol dependence
TI - Characteristics and correlates of U.S. clinicians prescribing buprenorphine for opioid use disorder treatment using expanded authorities during the COVID-19 pandemic
U1 - Education & Workforce; HIT & Telehealth; Opioids & Substance Use
U2 - 34049102
U3 - 10.1016/j.drugalcdep.2021.108783
VL - 225
VO - 1879-0046; 0376-8716
Y1 - 2021
Y2 - Aug 1
ER -