Primary care physicians' preparedness to treat opioid use disorder in the United States: A cross-sectional survey.
Primary care physicians' preparedness to treat opioid use disorder in the United States: A cross-sectional survey.
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DOI：
10.1016/j.drugalcdep.2021.108811
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发表时间：
2021-08-01
影响因子：
4.2
通讯作者：
Alexander, G. Caleb
中科院分区：
文献类型：
--
作者：
Foti, Kathryn;Heyward, James;Tajanlangit, Matthew;Meek, Kristin;Jones, Christopher;Kolodny, Andrew;Alexander, G. Caleb
增加阿片类药物使用障碍（OUD）治疗的努力集中在初级保健上。我们评估了初级保健医生识别和治疗OUD患者的准备情况以及增加丁丙诺啡处方的障碍。我们从2020年1月至8月进行了一项横断面调查，评估了对阿片类药物流行病的看法;舒适筛查，诊断和药物治疗OUD患者;以及在实践中获得丁丙诺啡豁免和处方丁丙诺啡的障碍。从美国医学会医师主文件（n = 1000）中抽取初级保健医生，并联系多达3次，两次通过邮件，一次通过电子邮件。总体而言，173名医生（调整后的应答率为27.3%）做出了应答。虽然大多数人对OUD的筛查（80.7%）和诊断（79.3%）感到有些或非常舒适，但很少有人（36.9%）对药物治疗OUD感到有些或非常舒适。三分之一的受访者在实践中，他们或一位同事被豁免，10. 7%的受访者有丁丙诺啡豁免。获得豁免和开丁丙诺啡处方的最常见障碍包括缺乏成瘾、行为健康或精神科共同管理，缺乏治疗OUD的经验，不喜欢被丁丙诺啡的要求淹没，以及丁丙诺啡培训要求。虽然大多数初级保健医生报告舒适筛查和诊断OUD，但很少有人愿意用丁丙诺啡等药物治疗OUD，甚至更少有人放弃这样做。解决供应商的自我效能和意愿，并确定有效的，协调的，全面的护理模式，可以增加使用丁丙诺啡的OUD治疗。
Efforts to increase opioid use disorder (OUD) treatment have focused on primary care. We assessed primary care physicians’ preparedness to identify and treat individuals with OUD and barriers to increasing buprenorphine prescribing. We conducted a cross-sectional survey from January–August 2020 which assessed perceptions of the opioid epidemic; comfort screening, diagnosing, and treating individuals with OUD with medications; and barriers to obtaining a buprenorphine waiver and prescribing buprenorphine in their practice. Primary care physicians were sampled from the American Medical Association Physician Master File (n = 1000) and contacted up to 3 times, twice by mail and once by e-mail. Overall, 173 physicians (adjusted response rate 27.3 %) responded. While most were somewhat or very comfortable screening (80.7 %) and diagnosing (79.3 %) OUD, fewer (36.9 %) were somewhat or very comfortable treating OUD with medications. One third of respondents were in a practice where they or a colleague were waivered and 10.7 % of respondents had a buprenorphine waiver. The most commonly cited barriers to both obtaining a waiver and prescribing buprenorphine included lack of access to addiction, behavioral health, or psychiatric co-management, lack of experience treating OUD, preference not to be inundated with requests for buprenorphine, and the buprenorphine training requirement. While most primary care physicians reported comfort screening and diagnosing OUD, fewer were comfortable treating OUD with medications such as buprenorphine and even fewer were waivered to do so. Addressing provider self-efficacy and willingness, and identifying effective, coordinated, and comprehensive models of care may increase OUD treatment with buprenorphine.
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对患者和提供者对阿片类药物使用障碍的治疗药物的观点的系统评价。
影响因子：
3.9
作者：
Cioe K;Biondi BE;Easly R;Simard A;Zheng X;Springer SA
通讯作者：
Springer SA
DOI：
10.31478/202004b
发表时间：
2020-01-01
期刊：
NAM perspectives
影响因子：
--
作者：
Madras, Bertha K;Ahmad, N Jia;Sharfstein, Joshua Sharfstein
通讯作者：
Sharfstein, Joshua Sharfstein
影响因子：
2.9
作者：
Hwang, Catherine S.;Turner, Lydia W.;Alexander, G. Caleb
通讯作者：
Alexander, G. Caleb
影响因子：
6
作者：
Jones, Christopher M.;McCance-Katz, Elinore F.
通讯作者：
McCance-Katz, Elinore F.
影响因子：
4.2
作者：
Jones, Christopher M.;McCance-Katz, Elinore F.
通讯作者：
McCance-Katz, Elinore F.