Evaluation of Resident Physicians’ Knowledge of and Attitudes Towards Prescribing Buprenorphine for Patients With Opioid Use Disorder

Shuey, Bryant; Lee, Dong Hoon; Ugalde, Israel; Borgan, Saif M.; Bresnan, Caroline; Qureshi, M. I.; Mhaskar, Rahul; Oxner, Asa

doi:10.1097/adm.0000000000000750

Cited by 16 publications

(26 citation statements)

References 18 publications

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“…Since buprenorphine was approved for the treatment of OUD by the FDA in 2002, many studies have examined attitudes toward buprenorphine and prescribing practices. Studies found that knowledge about buprenorphine, exposure to its use, and attitudes about its effectiveness and acceptability in treating OUD are related to prescribing practices 64 , 72 , 87 , 91 , 94 , 95 , 110 . Certain types of physicians, especially generalist physicians and addiction specialists, tend to be more open to prescribing buprenorphine 61 , 64 , 72 , 83 , 94 .…”

Section: Resultsmentioning

confidence: 99%

“…The most commonly endorsed barriers to prescribing buprenorphine include inadequate access to behavioral health, counseling, and other support services; logistical issues such as patient limits, DEA involvement, scheduling, and record-keeping; lack of knowledge about OUD treatment and need for additional training; and concerns about fit with practice and potential changes to the patient mix 64 , 65 , 76 , 77 , 83 , 86 , 87 , 91 , 92 , 95 , 101 , 109 , 110 . Netherland et al 76 .…”

Section: Resultsmentioning

confidence: 99%

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Health Professionals’ Attitudes toward Medications for Opioid use Disorder

Brown

2022

Substance Abuse

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Background: Research has shown that medications, especially opioid agonist treatments, are an effective way to treat opioid use disorder (OUD); however, negative attitudes held by health professionals contribute to their underutilization. Methods: A 23-year review of studies that examined health professionals’ attitudes toward medications for OUD (MOUD) was conducted to describe the current state of knowledge and to inform future research and interventions. Results: Studies examined attitudes toward the use of methadone, buprenorphine, and naltrexone among various types of health professionals: prescribers, non-prescribing clinicians, pharmacists, and administrators. The characteristics and findings of the included studies were reviewed and synthesized. Findings indicate that attitudes toward MOUD affect access and utilization by influencing prescribing practices, referrals, and adoption within programs. Exposure, knowledge, and treatment orientation were found to be important factors related to attitudes toward MOUD across multiple studies of various types of health professionals. Conclusions: To increase access and utilization, continued efforts are needed to increase positive attitudes toward MOUD among various types of health professionals. Findings indicate that interventions should seek to increase knowledge about MOUD and foster interprofessional communication related to MOUD, especially between prescribers and behavioral health providers.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Health Professionals’ Attitudes toward Medications for Opioid use Disorder

Brown

2022

Substance Abuse

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“…Other previously cited barriers to prescribing buprenorphine include insufficient reimbursement, lack of knowledge and expertise, lack of time or interest, and a perception that patients with OUD may be "high maintenance." [11][12][13] Some studies have identified logistical considerations surrounding prescribing including cumbersome regulations, inadequate office space and inadequately trained staff, as well as lack of institutional support and behavioral health resources. 14,15 Provider concerns about "opening the flood gates" to OUD patients and beliefs about the usefulness of MOUD have also been identified as barriers.…”

Section: Introductionmentioning

confidence: 99%

Buprenorphine Waiver Attitudes Among Primary Care Providers

Lai

Croghan

Ebbert

2022

J Prim Care Community Health

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Background: Despite efforts to improve access to Medications for Opioid Use Disorder (MOUD), such as buprenorphine, the number of opioid overdoses in the United States continues to rise. In April 2021, the Department of Health and Human Services removed the mandatory training requirement to obtain a buprenorphine waiver; the goal was to encourage more providers to prescribe buprenorphine, thus improving access. Little is known about the attitudes on buprenorphine prescribing after this policy change. Objective: The primary objective was to assess attitudes among primary care providers toward the removal of the buprenorphine waiver training requirement. A secondary objective was to identify other barriers to prescribing buprenorphine. Methods: We conducted a survey between September 15 and October 13, 2021 to assess the overall beliefs on the effectiveness of MOUD and attitudes toward the removal of the waiver training, current knowledge of buprenorphine, current practice styles related to screening for and treating OUD, and attitudes toward prescribing buprenorphine in the future. This survey was sent to 890 Mayo Clinic primary care providers in 5 US states. Results: One hundred twenty-three respondents (13.8%) completed the survey; 35.8% respondents agreed that the removal of the waiver training was a positive step. These respondents expressed a greater familiarity with the different formulations, pharmacology, and titration of buprenorphine. This group was also more likely to prescribe (or continue to prescribe) buprenorphine in the future. Approximately one-third (34.4%) of respondents reported perceived institutional support in prescribing buprenorphine. This group expressed greater confidence in diagnosing OUD, had greater familiarity with the different formulations, pharmacology, and titration of buprenorphine, and was more likely to prescribe (or continue to prescribe) buprenorphine in the future. Respondents who have been in practice for 11 to 20 years since completion of training were most likely to refer all OUD patients to specialists. Conclusions: Results of our survey suggests that simply removing the mandatory waiver training requirement is insufficient in positively changing attitudes toward buprenorphine prescribing. A key barrier is the perceived lack of institutional support. Future studies investigating effective ways to provide such support may help improve providers’ willingness to prescribe buprenorphine.

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“…Residents in primary care related specialties are also well positioned to apply learned SUD skills to their clinical practice as evaluation and management of chronic diseases other than addiction, such as diabetes and hypertension, are core to their training. Despite this clinical exposure, residency training in SUD prevention, screening, assessment, treatment and recovery is not as robust as warranted [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Beyond opioid prescribing: Evaluation of a substance use disorder curriculum for OBGYN residents

et al. 2022

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Objective Amidst the current opioid crisis, there is a need for better integration of substance use disorder screening and treatment across specialties. However, there is no consensus regarding how to best instruct OBGYN trainees in the clinical skills related to opioid and other substance use disorders (SUD). Study objectives were (1) to assess the effectiveness a SUD curriculum to improve self-reported competence among OBGYN residents and (2) to explore its effectiveness to improve attending evaluations of residents’ clinical skills as well as its feasibility and acceptability from the resident perspective. Methods A pilot 3-session curriculum was developed and adapted to SUD screening and treatment which included readings, didactics, and supervised outpatient clinical experiences for OBGYN post-graduate year 1 (PGY-1) residents rotating through an integrated OBGYN-SUD clinic. Eighteen residents completed pre and post clinical skills self-assessments (SUD screening, counseling, referring, Motivational Interviewing) using an adapted Zwisch Rating Scale (range 1–5). Scores were compared between time points using paired t-tests. Sub-samples also (a) were evaluated by the attending on three relevant Accreditation Council for Graduate Medical Education Milestones (ACGME) milestone sets using the web-based feedback program, myTIPreport (n = 10) and (b) completed a qualitative interview (n = 4). Results All PGY-1s (18/18) across three academic years completed the 3-session SUD curriculum. Clinical skill self-assessments improved significantly in all areas [SUD Screening (2.44 (0.98) vs 3.56 (0.62), p = <0.01); Counseling (1.81 (0.71) vs 3.56 (0.51), p = < .01; Referring (2.03 (0.74) vs 3.17 (0.71), p = < .01; Motivational Interviewing (1.94 (1.06) vs 3.33 (0.69), p = < .01)]. Milestone set levels assigned by attending evaluations (n = 10) also improved. Qualitative data (n = 4) revealed high acceptability; all curriculum components were viewed positively, and feedback was provided (e.g., desire for more patient exposures). Conclusion A pilot SUD curriculum tailored for OBGYN PGY-1 residents that goes beyond opioid prescribing to encompass SUD management is feasible, acceptable and likely effective at improving SUD core clinical skills.

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Evaluation of Resident Physicians’ Knowledge of and Attitudes Towards Prescribing Buprenorphine for Patients With Opioid Use Disorder

Cited by 16 publications

References 18 publications

Health Professionals’ Attitudes toward Medications for Opioid use Disorder

Health Professionals’ Attitudes toward Medications for Opioid use Disorder

Buprenorphine Waiver Attitudes Among Primary Care Providers

Beyond opioid prescribing: Evaluation of a substance use disorder curriculum for OBGYN residents

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