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Impact of Policy Change on Access to Medication for Opioid Use Disorder in Primary Care.

Publication ,  Journal Article
Krupp, J; Hung, F; LaChapelle, T; Yarrington, ME; Link, K; Choi, Y; Chen, H; Marais, AD; Sachdeva, N; Chakraborty, H; McKellar, MS
Published in: South Med J
April 2023

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 χ2 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.

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Published In

South Med J

DOI

EISSN

1541-8243

Publication Date

April 2023

Volume

116

Issue

4

Start / End Page

333 / 340

Location

United States

Related Subject Headings

  • Primary Health Care
  • Practice Patterns, Physicians'
  • Opioid-Related Disorders
  • Opiate Substitution Treatment
  • Humans
  • Health Services Accessibility
  • General & Internal Medicine
  • Cross-Sectional Studies
  • Buprenorphine
  • 11 Medical and Health Sciences
 

Citation

APA
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ICMJE
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Krupp, J., Hung, F., LaChapelle, T., Yarrington, M. E., Link, K., Choi, Y., … McKellar, M. S. (2023). Impact of Policy Change on Access to Medication for Opioid Use Disorder in Primary Care. South Med J, 116(4), 333–340. https://doi.org/10.14423/SMJ.0000000000001544
Krupp, Joanna, Frances Hung, Tina LaChapelle, Michael E. Yarrington, Katherine Link, Yujung Choi, Hillary Chen, et al. “Impact of Policy Change on Access to Medication for Opioid Use Disorder in Primary Care.South Med J 116, no. 4 (April 2023): 333–40. https://doi.org/10.14423/SMJ.0000000000001544.
Krupp J, Hung F, LaChapelle T, Yarrington ME, Link K, Choi Y, et al. Impact of Policy Change on Access to Medication for Opioid Use Disorder in Primary Care. South Med J. 2023 Apr;116(4):333–40.
Krupp, Joanna, et al. “Impact of Policy Change on Access to Medication for Opioid Use Disorder in Primary Care.South Med J, vol. 116, no. 4, Apr. 2023, pp. 333–40. Pubmed, doi:10.14423/SMJ.0000000000001544.
Krupp J, Hung F, LaChapelle T, Yarrington ME, Link K, Choi Y, Chen H, Marais AD, Sachdeva N, Chakraborty H, McKellar MS. Impact of Policy Change on Access to Medication for Opioid Use Disorder in Primary Care. South Med J. 2023 Apr;116(4):333–340.

Published In

South Med J

DOI

EISSN

1541-8243

Publication Date

April 2023

Volume

116

Issue

4

Start / End Page

333 / 340

Location

United States

Related Subject Headings

  • Primary Health Care
  • Practice Patterns, Physicians'
  • Opioid-Related Disorders
  • Opiate Substitution Treatment
  • Humans
  • Health Services Accessibility
  • General & Internal Medicine
  • Cross-Sectional Studies
  • Buprenorphine
  • 11 Medical and Health Sciences