Perceived need and availability of psychosocial interventions across buprenorphine prescriber specialties |
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| Institution: | 1. Addiction Center, Department of Psychiatry, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI 48109, United States;2. Center for Clinical Management Research (CCMR), Veterans Affairs Ann Arbor Healthcare System, 2800 Plymouth Rd, Ann Arbor, MI 48109, United States;3. University of Kentucky, Department of Behavioral Science and Center on Drug and Alcohol Research, 845 Angliana Avenue, Lexington, KY 40508, United States;1. Research Centre, Centre Hospitalier de l''Université de Montréal (CHUM), Montréal, Québec, Canada;2. Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada;3. Department of Family Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada;4. Addiction Research and Study Program, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada;5. Institut national de santé publique du Québec, Montréal, Québec, Canada;1. Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, USA;2. Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA;3. Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA;1. Palo Alto University, United States;2. Smith College, United States;1. West Virginia University, Department of Psychology, United States;2. Nemours/Alfred I. DuPont Hospital for Children, Center for Healthcare Delivery Science, United States;3. West Virginia University, Department of Behavioral Medicine & Psychiatry, United States;4. University of Alabama at Birmingham, Department of Biostatistics, United States;1. Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD 4200 Valley Road, Suite 1242, MD 20742, USA;2. Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, MD 4200 Valley Road, Suite 2242, College Park, MD 20742, USA;3. Department of Psychology, George Mason University, 4400 University Drive, 3F5, Fairfax, VA 22030, USA |
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| Abstract: | IntroductionPsychosocial interventions are often recommended as part of buprenorphine treatment for patients with opioid use disorder, but little is known about prescriber perspectives on their use and how this varies across buprenorphine prescriber specialties.MethodsA large US sample of physicians actively prescribing buprenorphine (n = 1174) was surveyed from July 2014 to January 2017. Analyses examined prescriber characteristics and their perceptions and use of psychosocial interventions across three groups of physicians: primary care providers (PCPs), addiction physicians/psychiatrists, and other physicians.ResultsAcross all prescribers, 93.3% (n = 1061) report most patients would benefit from formal counseling during buprenorphine treatment while only 36.4% (n = 414) believe there are adequate number of counselors in their communities. Among addiction physicians/psychiatrists, 75.9% (n = 416) report their treatment settings have the resources to provide psychiatric services to patients with complex psychiatric problems compared to 29.1% (n = 130) of PCPs and 29.6% (n = 39, p < .001) of other physicians. Addiction physicians/psychiatrists report a higher percentage of patients receive counseling from clinicians in their practice while PCPs report a higher percentage of patients receive counseling from external providers.ConclusionsThe majority of prescribers believe patients receiving buprenorphine would benefit from psychosocial interventions and there is variation in how these services are delivered. However, many prescribers, especially those without addiction or psychiatry backgrounds, report their settings do not have adequate psychosocial treatment resources for patients with complex psychosocial needs. Future work developing novel models of psychosocial interventions may be helpful to support prescribers to effectively treat complex patients with opioid use disorders. |
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