Prescribers’ satisfaction with delivering medications for opioid use disorder

Abstract Background Expanding access to medications for opioid use disorder (MOUD), such as buprenorphine and extended release (XR) naltrexone, is critical to addressing the US opioid epidemic, but little is known about prescriber satisfaction with delivering these two types of MOUD. The current study describes the satisfaction of prescribers delivering buprenorphine and XR-naltrexone while examining whether satisfaction is associated with current patient census and organizational environment. Methods As part of a cluster randomized clinical trial (RCT) focused on expanding access to medication for opioid use disorder, 41 MOUD prescribers in Florida, Ohio, and Wisconsin completed a web-based survey. The survey included measures of prescriber satisfaction with delivering buprenorphine treatment and XR-naltrexone. In addition, the survey measured several prescriber characteristics and their perceptions of the organizational environment. Results Prescribers were generally satisfied with their work in delivering these two types of MOUD. Prescribers reporting a greater number of patients (r = .46, p = .006), those who would recommend the center to others (r = .56, p < .001), and those reporting positive relationships with staff (r = .56, p < .001) reported significantly greater overall satisfaction with delivering buprenorphine treatment. Prescribers who more strongly endorsed feeling overburdened reported lower overall buprenorphine satisfaction (r = -.37, p = .02). None of the prescriber characteristics or perceptions of the organizational environment were significantly associated with overall satisfaction with delivering XR-naltrexone treatment. Conclusions The generally high levels of satisfaction with both types of MOUD is notable given that prescriber dissatisfaction can lead to turnover and impact intentions to leave the profession. Future research should continue to explore the prescriber characteristics and organizational factors associated with satisfaction in providing different types of MOUD. Registration ClinicalTrials.gov. NCT02926482. Date of registration: September 9, 2016. https://clinicaltrials.gov/ct2/show/NCT02926482.

Download Full-text

Impact of High Deductible Health Plans on Continuous Buprenorphine Treatment for Opioid Use Disorder

Journal of General Internal Medicine ◽

10.1007/s11606-021-07094-9 ◽

2021 ◽

Author(s):

Alene Kennedy-Hendricks ◽

Cameron J. Schilling ◽

Alisa B. Busch ◽

Elizabeth A. Stuart ◽

Haiden A. Huskamp ◽

...

Keyword(s):

Opioid Use Disorder ◽

Health Plans ◽

Opioid Use ◽

Buprenorphine Treatment

Download Full-text

Primary Care of Opioid use Disorder: The End of “the French Model”?

European Addiction Research ◽

10.1159/000506630 ◽

2020 ◽

Vol 26 (6) ◽

pp. 346-354 ◽

Cited By ~ 1

Author(s):

Julie Dupouy ◽

Sandy Maumus-Robert ◽

Yohann Mansiaux ◽

Antoine Pariente ◽

Maryse Lapeyre-Mestre

Keyword(s):

Primary Care ◽

Private Practice ◽

Primary Care Providers ◽

Opioid Use Disorder ◽

Care Providers ◽

Opioid Use ◽

Access To Treatment ◽

Cross Sectional ◽

Number Of Patients ◽

French Model

Background: In France, most patients with opioid use disorder (OUD) have been treated by buprenorphine, prescribed by general practitioners (GP) in private practice since 1996. This has contributed to building a ‘French model’ facilitating access to treatment based on the involvement of GPs in buprenorphine prescription. Objectives: Our study aimed to assess whether the involvement of primary care in OUD management has changed lately. Materials and Methods: Using data from the French National Health Insurance database, we conducted a yearly repeated cross-sectional study (2009–2015) and described proportion of opioid maintenance treatment (OMT)-prescribing GPs and OMT-dispensing community pharmacies (CP); and number of patients by GP or CP. Results: Whereas the number of buprenorphine-prescribing GPs in private practice remained quite stable (decrease of 3%), a substantial decrease in buprenorphine initial prescribers among private GPs was observed. In 2009, 10.3% of private GPs (6,297 from 61,301 French private GPs) prescribed buprenorphine for the initiation of a treatment, whereas they were 5.7% (n = 3,539 from 62,071 private GPs) in 2015 (43.8% decrease). GPs issuing initial prescriptions of buprenorphine tended to care for a higher number of patients treated by buprenorphine (14.6 ± 27.1 patients in 2009 to 16.0 ± 35.4 patients in 2015). The number of CPs dispensing buprenorphine remained quite stable (decrease of 2%), while there was a 7.5% decrease in the total number of French CPs across the study period. Conclusions: Our results suggest that primary care providers seem less engaged in buprenorphine initiation in OUD patients, while CPs have not modified their involvement towards these patients.

Download Full-text

Project ECHO and primary care buprenorphine treatment for opioid use disorder: Implementation and clinical outcomes

Substance Abuse ◽

10.1080/08897077.2021.1931633 ◽

2021 ◽

pp. 1-9

Author(s):

James B. Anderson ◽

Stephen A. Martin ◽

Anne Gadomski ◽

Nicole Krupa ◽

Daniel Mullin ◽

...

Keyword(s):

Primary Care ◽

Clinical Outcomes ◽

Opioid Use Disorder ◽

Opioid Use ◽

Project Echo ◽

Buprenorphine Treatment

Download Full-text

P.0315 Association between hazardous alcohol use and initiation of naltrexone treatment for opioid use disorder among hiv-positive persons in russia

European Neuropsychopharmacology ◽

10.1016/j.euroneuro.2021.10.298 ◽

2021 ◽

Vol 53 ◽

pp. S228-S229

Author(s):

M. Vetrova ◽

E.A. Blokhina ◽

D.M. Cheng ◽

V. Truong ◽

E.K. Quinn ◽

...

Keyword(s):

Alcohol Use ◽

Opioid Use Disorder ◽

Hiv Positive ◽

Opioid Use ◽

Hazardous Alcohol Use ◽

Hazardous Alcohol ◽

Naltrexone Treatment

Download Full-text

Buprenorphine Induction in a Rural Maryland Detention Center During COVID-19: Implementation and Preliminary Outcomes of a Novel Telemedicine Treatment Program for Incarcerated Individuals With Opioid Use Disorder

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.703685 ◽

2021 ◽

Vol 12 ◽

Author(s):

Annabelle M. Belcher ◽

Kelly Coble ◽

Thomas O. Cole ◽

Christopher J. Welsh ◽

Anna Whitney ◽

...

Keyword(s):

Opioid Use Disorder ◽

Community Treatment ◽

Successful Implementation ◽

Opioid Use ◽

Screening Process ◽

Detention Center ◽

Medication Prescription ◽

Proven Efficacy ◽

Pass Through ◽

Buprenorphine Treatment

Over 10 million individuals pass through U.S. detention centers on an annual basis, with nearly two-thirds meeting criteria for drug dependence/abuse. Despite proven efficacy, treatment with medications for opioid use disorder (MOUD) is underutilized in jail settings—a gap that could be addressed using telemedicine. Here we describe a new program of telemedicine-based clinical provision of new/continuing buprenorphine treatment for individuals detained in a rural jail. Implementation objectives were completed between January and August 2020, and patient encounters were conducted between August 2020 and February 2021. We established (i) telemedicine hardware/software capability; (ii) a screening process; (iii) buprenorphine administration methods; (iv) necessary medical release procedures; (v) telemedicine encounter coordination and medication prescription procedures; and (vi) a research platform. Seven incarcerated patients have been treated, two of whom were referred from community treatment. Patients were mostly male (71%), non-Hispanic White (86%), and averaged 33 years old. All patients tested positive for an opioid upon intake and began/continued buprenorphine treatment in the jail. Average time to first MOUD appointment was 9 days and patients were maintained in treatment an average 21 days. Referrals for continuing community treatment were offered to all patients prior to discharge. We report successful implementation of telemedicine MOUD in a rural detention center, with treatment engagement and initiation occurring prior to the high-risk period of discharge. The fact that this program was launched during the height of the pandemic highlights the flexibility of telemedicine-based buprenorphine treatment. Challenges and obstacles to implementation of buprenorphine treatment in a correctional system are discussed.

Download Full-text