Increasing Access to Buprenorphine in Safety-Net Primary Care Clinics: The New York City Buprenorphine Nurse Care Manager Initiative

Kaplan-Dobbs, Marissa; Kattan, Jessica; Tuazon, Ellenie; Jimenez, Christian; Saleh, Sabina; Kunins, Hillary V.

doi:10.2105/ajph.2020.306000

Cited by 14 publications

(15 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most patients who received care were male (74%), Medicaid beneficiaries (72%), and Latinx or Hispanic (42%) or Black (21%). The initiative resulted in 116 new buprenorphine prescribers, and the number of buprenorphine prescriptions filled in New York City increased by 25% in the first 2 years of the program (Kaplan‐Dobbs et al, 2021).…”

Section: Resultsmentioning

confidence: 99%

“…The studies in this review focused on improving nurse–patient relationships, instead of solely focusing on patient‐level factors (i.e., disease management), to improve the quality of care received. Nursing care during treatment with medications for OUD also directly improved participants' physical and mental health outcomes in the nursing models of care described in New York City and Boston (Alford et al, 2011; Kaplan‐Dobbs et al, 2021). Therefore, further research is needed to improve and expand the role of nurses in OUD treatment settings to facilitate patient‐centered care delivery.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The impact of nursing on health outcomes of people receiving medication for opioid use disorder: An integrative review

Alexander

Smith

Gerolamo

et al. 2022

J of Nursing Scholarship

View full text Add to dashboard Cite

Introduction This integrative review aimed to understand the impact of nursing on the health outcomes of people with opioid use disorder (OUD). Methods Whittemore and Knafl's (2005) integrative review methodology guided the review process. The authors searched PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and OVID databases for peer‐reviewed, English language articles describing nursing care for people receiving medications for OUD. The literature search followed the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guidelines. Results A total of 773 articles were identified through the database searches after duplicates were removed; 15 articles met inclusion criteria and were included in the final review from the United States, Canada, Ireland, England, and the Netherlands. Two themes emerged: (1) The effect of nurse‐led care on patient outcomes and (2) Nursing roles and the environment of care. Studies emphasized the aspects of nursing care that promote patient‐centeredness and patient satisfaction. Conclusions The importance of the registered nurse in providing quality care for people receiving medications for OUD is clear from the literature reviewed. The studies in the review highlighted important aspects of the registered nurses' role in affecting outcomes for people receiving medications for OUD including communication and care coordination. Clinical relevance This review highlights the need for role delineation and further development of nurse‐sensitive indicators in the OUD treatment setting.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The impact of nursing on health outcomes of people receiving medication for opioid use disorder: An integrative review

Alexander

Smith

Gerolamo

et al. 2022

J of Nursing Scholarship

View full text Add to dashboard Cite

show abstract

“…[33][34][35] Support for buprenorphine prescribers like that provided by New Jersey's 2 MAT COEs, can also increase buprenorphine prescribing. [35][36][37] Importantly, synergistic factors unique to New Jersey may account for the changes in buprenorphine use and prescribing observed in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Prior authorizations are a commonly cited barrier to buprenorphine prescribing, and eliminating prior authorization requirements has been shown to increase treatment access . Efforts like New Jersey’s OBAT program, which increase reimbursement and assist prescribers in addressing patients’ psychosocial needs, have similarly found success in expanding availability and utilization of treatment services . Support for buprenorphine prescribers like that provided by New Jersey’s 2 MAT COEs, can also increase buprenorphine prescribing .…”

Section: Discussionmentioning

confidence: 99%

“… 31 , 32 Efforts like New Jersey’s OBAT program, which increase reimbursement and assist prescribers in addressing patients’ psychosocial needs, have similarly found success in expanding availability and utilization of treatment services. 33 , 34 , 35 Support for buprenorphine prescribers like that provided by New Jersey’s 2 MAT COEs, can also increase buprenorphine prescribing. 35 , 36 , 37 Importantly, synergistic factors unique to New Jersey may account for the changes in buprenorphine use and prescribing observed in this study.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Buprenorphine Utilization and Prescribing Among New Jersey Medicaid Beneficiaries After Adoption of Initiatives Designed to Improve Treatment Access

et al. 2023

View full text Add to dashboard Cite

ImportanceBuprenorphine is underutilized as a treatment for opioid use disorder (OUD); state policies may improve buprenorphine access and utilization.ObjectiveTo assess buprenorphine prescribing trends following New Jersey Medicaid initiatives designed to improve access.Design, Setting, and ParticipantsThis cross-sectional interrupted time series analysis included New Jersey Medicaid beneficiaries who were prescribed buprenorphine and had 12 months continuous Medicaid enrollment, OUD diagnosis, and no Medicare dual eligibility, as well as physician or advanced practitioners who prescribed buprenorphine to Medicaid beneficiaries. The study used Medicaid claims data from 2017 to 2021.ExposureImplementation of New Jersey Medicaid initiatives in 2019 that removed prior authorizations, increased reimbursement for office-based OUD treatment, and established regional Centers of Excellence.Main Outcomes and MeasuresRate of buprenorphine receipt per 1000 beneficiaries with OUD; percentage of new buprenorphine episodes lasting at least 180 days; buprenorphine prescribing rate per 1000 Medicaid prescribers, overall and by specialty.ResultsOf 101 423 Medicaid beneficiaries (mean [SD] age, 41.0 [11.6] years; 54 726 [54.0%] male; 30 071 [29.6%] Black, 10 143 [10.0%] Hispanic, and 51 238 [50.5%] White), 20 090 filled at least 1 prescription for buprenorphine from 1788 prescribers. Policy implementation was associated with an inflection point in buprenorphine prescribing trend; after implementation, the trend increased by 36%, from 1.29 (95% CI, 1.02-1.56) prescriptions per 1000 beneficiaries with OUD to 1.76 (95% CI, 1.46-2.06) prescriptions per 1000 beneficiaries with OUD. Among beneficiaries with new buprenorphine episodes, the percentage retained for at least 180 days was stable before and after initiatives were implemented. The initiatives were associated with an increase in the growth rate of buprenorphine prescribers (0.43 per 1000 prescribers; 95% CI, 0.34 to 0.51 per 1000 prescribers). Trends were similar across specialties, but increases were most pronounced among primary care and emergency medicine physicians (eg, primary care: 0.42 per 1000 prescribers; 95% CI, 0.32-0.53 per 1000 prescribers). Advanced practitioners accounted for a growing percentage of buprenorphine prescribers, with a monthly increase of 0.42 per 1000 prescribers (95% CI, 0.32-0.52 per 1000 prescribers). A secondary analysis to test for changes associated with non–state-specific secular trends in prescribing found that quarterly trends in buprenorphine prescriptions increased in New Jersey relative to all other states following initiative implementation.Conclusions and RelevanceIn this cross-sectional study of state-level New Jersey Medicaid initiatives designed to expand buprenorphine access, implementation was associated with an upward trend in buprenorphine prescribing and receipt. No change was observed in the percentage of new buprenorphine treatment episodes lasting 180 or more days, indicating that retention remains a challenge. Findings support implementation of similar initiatives but highlight the need for efforts to support long-term retention.

show abstract

NYC RxStat: Stakeholder perspectives on a national model public health and public safety partnership to reduce overdose deaths

Allen

Urmanche

2023

Evaluation and Program Planning

View full text Add to dashboard Cite

Increasing Access to Buprenorphine in Safety-Net Primary Care Clinics: The New York City Buprenorphine Nurse Care Manager Initiative

Cited by 14 publications

References 4 publications

The impact of nursing on health outcomes of people receiving medication for opioid use disorder: An integrative review

The impact of nursing on health outcomes of people receiving medication for opioid use disorder: An integrative review

Buprenorphine Utilization and Prescribing Among New Jersey Medicaid Beneficiaries After Adoption of Initiatives Designed to Improve Treatment Access

NYC RxStat: Stakeholder perspectives on a national model public health and public safety partnership to reduce overdose deaths

Contact Info

Product

Resources

About