Characteristics and correlates of U.S. clinicians prescribing buprenorphine for opioid use disorder treatment using expanded authorities during the COVID-19 pandemic
Autor: | Joshua G. Schier, Wilson M. Compton, Christopher M. Jones, Matthew Eisenstat, Mamadou M. Diallo, Meena Vythilingam |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Adult
Male medicine.medical_specialty Telemedicine Telehealth Toxicology Drug Prescriptions Article Health Services Accessibility 03 medical and health sciences 0302 clinical medicine Pandemic medicine Humans Pharmacology (medical) 030212 general & internal medicine Expanded Authorities Practice Patterns Physicians' Pandemics Aged Pharmacology business.industry COVID-19 Opioid use disorder Opioid overdose Middle Aged medicine.disease Opioid-Related Disorders United States Buprenorphine Psychiatry and Mental health Expanded access Family medicine Health Care Surveys Female business 030217 neurology & neurosurgery medicine.drug |
Zdroj: | Drug Alcohol Depend |
Popis: | Background To determine how clinicians with a DATA waiver to prescribe buprenorphine for opioid use disorder (OUD) adapted during the COVID-19 pandemic to emergency authorities, including use of telehealth to prescribe buprenorphine, the challenges faced by clinicians, and strategies employed by them to manage patients with OUD. Methods From June 23, 2020 to August 19, 2020, we conducted an electronic survey of U.S. DATA-waivered clinicians. Descriptive statistics and multivariable logistic regression were used for analysis. Results Among 10,238 respondents, 68 % were physicians, 25 % nursing-related providers, and 6% physician assistants; 28 % reported never prescribing or not prescribing in the 12 months prior to the survey. Among the 72 % of clinicians who reported past 12-month buprenorphine prescribing (i.e. active practitioners during the pandemic) 30 % reported their practice setting closed to in-person visits during COVID-19; 33 % reported remote prescribing to new patients without an in-person examination. The strongest predictors of remote buprenorphine prescribing to new patients were prescribing buprenorphine to larger numbers of patients in an average month in the past year and closure of the practice setting during the pandemic; previous experience with remote prescribing to established patients prior to COVID-19 also was a significant predictor. Among clinicians prescribing to new patients without an in-person examination, 5.5 % reported difficulties with buprenorphine induction, most commonly withdrawal symptoms. Conclusions Telehealth practices and prescribing to new patients without an in-person examination were adopted by DATA-waivered clinicians during the first six months of COVID-19. Permanent adoption of these authorities may enable expanded access to buprenorphine treatment. |
Databáze: | OpenAIRE |
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