Buprenorphine Treatment By Primary Care Providers, Psychiatrists, Addiction Specialists, And Others.
Buprenorphine Treatment By Primary Care Providers, Psychiatrists, Addiction Specialists, And Others.
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DOI：
10.1377/hlthaff.2019.01622
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发表时间：
2020-06
期刊：
影响因子：
9.7
通讯作者：
King, Marissa
中科院分区：
文献类型：
--
作者：
Olfson, Mark;Zhang, Victoria;Schoenbaum, Michael;King, Marissa
阿片类药物相关发病率和死亡率的大幅增加促使联邦政策的实施，以扩大初级保健提供者和其他临床医生的丁丙诺啡处方能力。我们利用 2010-18 年覆盖美国 72-92% 人口的国家处方数据库，分析了按处方医生专业划分的丁丙诺啡治疗趋势。初级保健提供者的丁丙诺啡治疗率从 2010 年的每 10,000 人 12.9 人增加到 2018 年的 27.4 人。精神科医生和成瘾医学专家的人数从每 10,000 人 8.7 人增加到 12.0 人，其他处方医师的人数从每 10,000 人 5.8 人增加到 16.3 人。然而，初级保健提供者、精神科医生和成瘾医学专家对 15-24 岁人群的治疗显着下降。在所有患者年龄和提供者组中，大多数患者没有在至少 180 天的基准期内保留丁丙诺啡治疗。尽管最近全国范围内丁丙诺啡治疗的增加主要是由非专业人士推动的，但丁丙诺啡的获取（尤其是年轻人）以及保留患者长期治疗的挑战仍然存在。
Substantial increases in opioid-related morbidity and mortality have motivated the implementation of federal policies to expand the buprenorphine prescribing capacity of primary care providers and other clinicians. Using a national prescription database that covered 72–92 percent of the US population during 2010–18, we analyzed trends in buprenorphine treatment by prescriber specialty. Buprenorphine treatment rates by primary care providers increased from 12.9 people per 10,000 population in 2010 to 27.4 in 2018. The numbers for psychiatrists and addiction medicine specialists increased from 8.7 to 12.0 per 10,000 and those for other prescribers from 5.8 to 16.3 per 10,000. However, treatment of people ages 15–24 by primary care providers and by psychiatrists and addiction medicine specialists declined significantly. Across all patient age and provider groups, most patients were not retained on buprenorphine for the benchmark period of at least 180 days. Despite a recent national increase in buprenorphine treatment fueled primarily by nonspecialists, challenges persist with buprenorphine access—especially for younger people—and with retaining patients in long-term treatment.
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