TY - JOUR
KW - buprenorphine
KW - graduate medication education
KW - knowledge, practices, and attitudes
KW - Office-based opioid treatment
AU - Lello Tesema
AU - Jeffrey Marshall
AU - Rachel Hathaway
AU - Christina Pham
AU - Camille Clarke
AU - Genevieve Bergeron
AU - James Yeh
AU - Michael Soliman
AU - Danny McCormick
A1 - 
AB - BACKGROUND: The prevalence of opioid use disorder (OUD) has increased sharply. Office-based opioid treatment with buprenorphine (OBOT) is effective but often underutilized because of physicians' lack of experience prescribing this therapy. Little is known about US residency training programs' provision of OBOT and addiction medicine training. METHODS: The authors conducted a survey of residency program directors (RPDs) at all US residency programs in internal medicine, family medicine, and psychiatry to assess the frequency with which their residents provide care for OUD, presence and features of curricula in OBOT and addiction medicine, RPDs' beliefs about OBOT, and potential barriers to providing OBOT training. RESULTS: The response rate was 49.5% (476 of 962). Although 76.9% of RPDs reported that residents frequently manage patients with OUD, only 23.5% reported that their program dedicates 12 or more hours of curricular time to addiction medicine, 35.9% reported that their program encourages/requires training in OBOT, and 22.6% reported that their program encourages/requires obtaining a Drug Enforcement Administration (DEA) waiver to prescribe buprenorphine. Most RPDs believe that OBOT is an important treatment option for OUD (88.1%) and that increased residency training in OBOT would improve access to OBOT (73.7%). The authors also found that programs whose RPD had favorable views of OBOT were more likely to provide OBOT and addiction medicine training. Psychiatry programs were most likely to provide OBOT training and their RPDs most likely to have beliefs about OBOT that were positive. Commonly cited barriers to implementing OBOT training include a lack of waivered preceptors (76.9%), competing curricular priorities (64.1%), and a lack of support (social work and counseling) services (54.0%). CONCLUSIONS: Internal medicine, family medicine, and psychiatry residents often care for patients with OUD, and most RPDs believe that increased residency training in OBOT would increase access to this treatment. Yet, only a minority of programs offer training in OBOT.
AD - a Los Angeles County Department of Health Services , Los Angeles , California , USA.; b Department of Pulmonary and Critical Care Medicine , Yale University , New Haven , Connecticut , USA.; c Department of Medicine , Cambridge Health Alliance , Cambridge , Massachusetts , USA.; d Department of Medicine , University of California , San Francisco , California , USA.; e Department of Medicine, School of Medicine , Loma Linda University , Loma Linda , California , USA.; c Department of Medicine , Cambridge Health Alliance , Cambridge , Massachusetts , USA.; f Department of Medicine , Brigham and Women's Hospital , Boston , Massachusetts , USA.; g Department of Medicine , Beth Israel Deaconess Medical Center , Boston , Massachusetts , USA.; c Department of Medicine , Cambridge Health Alliance , Cambridge , Massachusetts , USA.
BT - Substance abuse
C5 - Education & Workforce; Opioids & Substance Use
CY - United States
DO - 10.1080/08897077.2018.1449047
JF - Substance abuse
LA - eng
M1 - Journal Article
N2 - BACKGROUND: The prevalence of opioid use disorder (OUD) has increased sharply. Office-based opioid treatment with buprenorphine (OBOT) is effective but often underutilized because of physicians' lack of experience prescribing this therapy. Little is known about US residency training programs' provision of OBOT and addiction medicine training. METHODS: The authors conducted a survey of residency program directors (RPDs) at all US residency programs in internal medicine, family medicine, and psychiatry to assess the frequency with which their residents provide care for OUD, presence and features of curricula in OBOT and addiction medicine, RPDs' beliefs about OBOT, and potential barriers to providing OBOT training. RESULTS: The response rate was 49.5% (476 of 962). Although 76.9% of RPDs reported that residents frequently manage patients with OUD, only 23.5% reported that their program dedicates 12 or more hours of curricular time to addiction medicine, 35.9% reported that their program encourages/requires training in OBOT, and 22.6% reported that their program encourages/requires obtaining a Drug Enforcement Administration (DEA) waiver to prescribe buprenorphine. Most RPDs believe that OBOT is an important treatment option for OUD (88.1%) and that increased residency training in OBOT would improve access to OBOT (73.7%). The authors also found that programs whose RPD had favorable views of OBOT were more likely to provide OBOT and addiction medicine training. Psychiatry programs were most likely to provide OBOT training and their RPDs most likely to have beliefs about OBOT that were positive. Commonly cited barriers to implementing OBOT training include a lack of waivered preceptors (76.9%), competing curricular priorities (64.1%), and a lack of support (social work and counseling) services (54.0%). CONCLUSIONS: Internal medicine, family medicine, and psychiatry residents often care for patients with OUD, and most RPDs believe that increased residency training in OBOT would increase access to this treatment. Yet, only a minority of programs offer training in OBOT.
PP - United States
PY - 2018
SN - 1547-0164; 0889-7077
SP - 1
EP - 7
EP - 
T1 - Training in office-based opioid treatment with buprenorphine in US residency programs: A national survey of residency program directors
T2 - Substance abuse
TI - Training in office-based opioid treatment with buprenorphine in US residency programs: A national survey of residency program directors
U1 - Education & Workforce; Opioids & Substance Use
U2 - 29513136
U3 - 10.1080/08897077.2018.1449047
VO - 1547-0164; 0889-7077
Y1 - 2018
Y2 - Mar 7
ER -