Analysis of barriers to adoption of buprenorphine maintenance therapy by family physicians
- PMID: 25651434
Analysis of barriers to adoption of buprenorphine maintenance therapy by family physicians
Abstract
Introduction: Opioid abuse has reached epidemic levels. Evidence-based treatments such as buprenorphine maintenance therapy (BMT) remain underutilized. Offering BMT in primary care settings has the potential to reduce overall costs of care, decrease medical morbidity associated with opioid dependence, and improve treatment outcomes. However, access to BMT, especially in rural areas, remains limited. This article will present a review of barriers to adoption of BMT among family physicians in a primarily rural area in the USA.
Methods: An anonymous survey of family physicians practicing in Vermont or New Hampshire, two largely rural states, was conducted. The survey included both quantitative and qualitative questions, focused on BMT adoption and physician opinions of opioids. Specific factors assessed included physician factors, physicians' understanding of patient factors, and logistical issues.
Results: One-hundred and eight family physicians completed the survey. Approximately 10% were buprenorphine prescribers. More than 80% of family physicians felt they regularly saw patients addicted to opiates. The majority (70%) felt that they, as family physicians, bore responsibility for treating opiate addiction. Potential logistical barriers to buprenorphine adoption included inadequately trained staff (88%), insufficient time (80%), inadequate office space (49%), and cumbersome regulations (37%). Common themes addressed in open-ended questions included lack of knowledge, time, or interest; mistrust of people with addiction or buprenorphine; and difficult patient population.
Conclusions: This study aims to quantify perceived barriers to treatment and provide insight expanding the community of family physicians offering BMT. The results suggest family physicians are excellent candidates to provide BMT, as most report regularly seeing opioid-addicted patients and believe that treating opioid addiction is their responsibility. Significant barriers remain, including inadequate staff training, lack of access to addiction experts, and perceived efficacy of BMT. Addressing these barriers may lower resistance to buprenorphine adoption and increase access to BMT in rural areas.
Keywords: Alcohol and Drug; Epidemiology; Evidence-based Care; General/Family Practice; Health Needs Assessment; Health Service reform; Medical; Mental Health; North America; Primary Health Care; Psychiatry; Public Health; Qualitative Research.
Similar articles
-
Geographic and specialty distribution of US physicians trained to treat opioid use disorder.Ann Fam Med. 2015 Jan-Feb;13(1):23-6. doi: 10.1370/afm.1735. Ann Fam Med. 2015. PMID: 25583888 Free PMC article.
-
Implementing buprenorphine in addiction treatment: payer and provider perspectives in Ohio.Subst Abuse Treat Prev Policy. 2015 Mar 28;10:13. doi: 10.1186/s13011-015-0009-2. Subst Abuse Treat Prev Policy. 2015. PMID: 25884206 Free PMC article.
-
Integrating buprenorphine treatment into office-based practice: a qualitative study.J Gen Intern Med. 2009 Feb;24(2):218-25. doi: 10.1007/s11606-008-0881-9. Epub 2008 Dec 17. J Gen Intern Med. 2009. PMID: 19089500 Free PMC article.
-
Statement of the American Society Of Addiction Medicine Consensus Panel on the use of buprenorphine in office-based treatment of opioid addiction.J Addict Med. 2011 Dec;5(4):254-63. doi: 10.1097/ADM.0b013e3182312983. J Addict Med. 2011. PMID: 22042215
-
Unobserved "home" induction onto buprenorphine.J Addict Med. 2014 Sep-Oct;8(5):299-308. doi: 10.1097/ADM.0000000000000059. J Addict Med. 2014. PMID: 25254667 Review.
Cited by
-
Overview of best practices for buprenorphine initiation in the emergency department.Int J Emerg Med. 2024 Feb 19;17(1):23. doi: 10.1186/s12245-024-00593-6. Int J Emerg Med. 2024. PMID: 38373992 Free PMC article.
-
Healthcare provider perspectives on emergency department-initiated buprenorphine/naloxone: a qualitative study.BMC Health Serv Res. 2024 Feb 15;24(1):211. doi: 10.1186/s12913-023-10271-7. BMC Health Serv Res. 2024. PMID: 38360620 Free PMC article.
-
A Qualitative Exploration of the Potential Role of Using Online Social Media Support Communities to Increase Initiation of Medications for Opioid Use Disorder (MOUD).J Subst Use. 2023;28(6):880-886. doi: 10.1080/14659891.2022.2098846. Epub 2023 Jan 8. J Subst Use. 2023. PMID: 38274090 Free PMC article.
-
Harm reduction in undergraduate and graduate medical education: a systematic scoping review.BMC Med Educ. 2023 Dec 21;23(1):986. doi: 10.1186/s12909-023-04931-9. BMC Med Educ. 2023. PMID: 38129846 Free PMC article.
-
Stigma towards opioid use disorder in primary care remain a barrier to integrating software-based measurement based care.BMC Psychiatry. 2023 Oct 24;23(1):776. doi: 10.1186/s12888-023-05267-w. BMC Psychiatry. 2023. PMID: 37875835 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical