Prescribing patterns of buprenorphine waivered physicians
| Autor: | Alexis Horan, Cindy Parks Thomas, Joel Dubenitz, Erin Doyle, Peter Kreiner, Bradley D. Stein, Christopher M. Jones |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty 030508 substance abuse Toxicology Drug Prescriptions California 03 medical and health sciences 0302 clinical medicine Physicians Medicine Humans Pharmacology (medical) 030212 general & internal medicine Medical prescription Maine Practice Patterns Physicians' Psychiatry health care economics and organizations Addiction treatment Ohio Pharmacology business.industry Opioid use Background data Prescription monitoring program Opioid-Related Disorders Waiver Buprenorphine Analgesics Opioid Psychiatry and Mental health Emergency medicine Treatment episode Prescription Drug Monitoring Programs Female 0305 other medical science business medicine.drug |
| Zdroj: | Drug and alcohol dependence. 181 |
| ISSN: | 1879-0046 |
| Popis: | Background DATA 2000 enabled physicians with approved training to be waivered to prescribe buprenorphine for the treatment of opioid use disorders (OUD) for a limited number of patients. A rule change in 2016 increased the patient limit for certain buprenorphine waivered physicians from 100 to 275. This study examines the prescribing patterns of buprenorphine prescribers by waiver limit status (30- or 100-patient limit). Methods Prescription Monitoring Program (PMP) data from Ohio, California, and Maine were used to identify prescriptions for buprenorphine for OUD from January 2010 to April 2015. Analysis of prescribing patterns by prescriber waiver status included monthly patient censuses and treatment episode duration by state, year, and the frequency with which prescribers were near their respective patient limits. Results In the three states, 8638 physicians initiated 468,148 buprenorphine episodes. The adjusted mean monthly patient census was 42.9 for 100-patient waivered prescribers, 13.6 patients for 30-patient waivered prescribers, and 7.6 patients for prescribers unassociated with a waiver. Half (48.5%) of episodes were associated with 100-patient waivered prescribers, 26.9% with 30-patient waivered prescribers, and 24.4% with non-waivered prescribers. 30-patient waivered physicians were more likely to have no buprenorphine treatment episodes in a given month than 100-patient waivered prescribers. Conclusions Most buprenorphine prescribers practice well under their current patient limit and have numerous months with no patient episodes. For the few high prescribers, increasing the maximum patient limit beyond 100 has the potential to improve access but alone may not have widespread impact unless integrated into complementary approaches toward increasing prescriber capacity. |
| Databáze: | OpenAIRE |
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