TY - JOUR
AU - J. Krupp
AU - F. Hung
AU - T. LaChapelle
AU - M. E. Yarrington
AU - K. Link
AU - Y. Choi
AU - H. Chen
AU - A. D. Marais
AU - N. Sachdeva
AU - H. Chakraborty
AU - M. S. McKellar
A1 - 
AB - OBJECTIVES: 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.
AD - From the Duke University School of Medicine.;Department of Biostatistics and Bioinformatics, Duke University School of Medicine.;Initiative on Survey Methodology, Duke University.;Department of Medicine, Division of Infectious Diseases, Duke University School of Medicine.;Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina.
AN - 37011580
BT - South Med J
C5 - Opioids & Substance Use; Healthcare Policy; Education & Workforce
CP - 4
DA - Apr
DO - 10.14423/smj.0000000000001544
DP - NLM
IS - 4
JF - South Med J
LA - eng
N2 - OBJECTIVES: 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.
PY - 2023
SN - 0038-4348 (Print);0038-4348
SP - 333
EP - 340+
ST - Impact of Policy Change on Access to Medication for Opioid Use Disorder in Primary Care
T1 - Impact of Policy Change on Access to Medication for Opioid Use Disorder in Primary Care
T2 - South Med J
TI - Impact of Policy Change on Access to Medication for Opioid Use Disorder in Primary Care
U1 - Opioids & Substance Use; Healthcare Policy; Education & Workforce
U3 - 10.14423/smj.0000000000001544
VL - 116
VO - 0038-4348 (Print);0038-4348
Y1 - 2023
ER -