Prevalence, Distribution, and Characteristics Associated With Possession of Buprenorphine Waivers Among Infectious Diseases Physicians in the United States.

Autor:	Fujita AW; Division of Infectious Diseases, Emory University Department of Medicine, Atlanta, Georgia, USA., Loughry N; Division of General Internal Medicine, Emory University Department of Medicine, Atlanta, Georgia, USA., Moore DE; Department of Biostatistics, Emory University Department of Medicine, Rollins School of Public Health, Atlanta, Georgia, USA., Carter AE; Division of General Internal Medicine, University of Pittsburgh Department of Medicine, Pittsburgh, Pennsylvania, USA., Hussen SA; Division of Infectious Diseases, Emory University Department of Medicine, Atlanta, Georgia, USA.; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA., Cooper H; Department of Behavioral, Social, and Health Education Services, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA., Colasanti JA; Division of Infectious Diseases, Emory University Department of Medicine, Atlanta, Georgia, USA., Sheth AN; Division of Infectious Diseases, Emory University Department of Medicine, Atlanta, Georgia, USA.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2023 Apr 03; Vol. 76 (7), pp. 1197-1204.
DOI:	10.1093/cid/ciac909
Abstrakt:	Background: Persons with opioid use disorder (OUD) may present with infectious complications from injection drug use; thus, infectious diseases (ID) physicians are uniquely positioned to treat OUD. Buprenorphine is safe and effective for OUD but remains underutilized. The prevalence and geographic distribution of ID physicians who are waivered to prescribe buprenorphine are unknown. Methods: This cross-sectional study merged data from several publicly available datasets from 1 November 2021 to 15 January 2022. Our primary outcome was the proportion of ID physicians possessing buprenorphine waivers in the United States. We identified individual- and county-level characteristics associated with buprenorphine waiver possession. We then used geospatial analysis to determine the geographic distribution of waivered ID physicians. Results: We identified 6372 ID physicians in the United States, among whom 170 (2.7%) possessed waivers. Most ID physicians (97.3%) practiced in metropolitan counties. In our multivariable analysis, ID physicians had lower odds of having a waiver for every 10-year increase since graduating medical school (OR: .79; 95% CI: .68-.91). ID physicians practicing in counties with a higher proportion of uninsured residents had lower odds of having a waiver (OR: .75; 95% CI: .62-.90). Among counties with ≥1 ID physician (n = 729), only 11.2% had ≥1 waivered ID physician. Conclusions: We found an extremely low prevalence and skewed geographic distribution of ID physicians with buprenorphine waivers. Our findings suggest an urgent need to increase the workforce of ID physicians waivered to prescribe buprenorphine and a call for increased integration of OUD education into ID training and continuing medical education. Competing Interests: Potential conflicts of interest. The authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. (© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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