Medications for opioid use disorder in rural primary care practices: Patient and provider experiences

Bridges, Nora C.; Taber, Rachel; Foulds, Abigail; Bear, Todd; Cloutier, Renee M.; McDonough, Brianna L.; Gordon, Adam J.; Cochran, Gerald; Donohue, Julie M.; Adair, Dale; DiDomenico, Ellen; Pringle, Jan; Gellad, Walid F.; Kelley, David; Cole, Evan S.

doi:10.1016/j.josat.2023.209133

Cited by 2 publications

(2 citation statements)

References 31 publications

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“…This is consistent with other studies that have indicated rapport and trust in patient-provider relationships are important factors in providing MOUD, particularly within rural practice settings. 39 Additionally, Madden, et al 40 reported in a recent systematic review that intervention stigma (eg, prejudice and discrimination) associated with MOUD among providers is an important barrier in broader MOUD implementation and uptake.…”

Section: Discussionmentioning

confidence: 99%

Primary Care Providers’ Experiences Treating Opioid Use Disorder Using Telehealth in the Height of the COVID-19 Pandemic

Marshall,

Siebenmorgen,

Youngen

et al. 2024

J Prim Care Community Health

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Background: The COVID-19 pandemic catalyzed a rapid shift in healthcare delivery towards telehealth services, impacting patient care, including opioid use disorder (OUD) treatment. Regulatory changes eliminated the in-person evaluation requirement for buprenorphine treatment, encouraging adoption of telehealth. This study focused on understanding experiences of primary care providers in predominantly rural areas who used telehealth for OUD treatment during the pandemic. Methods: Semi-structured interviews were conducted with 22 primary care providers. Participants practiced in 13 rural and 9 urban counties in Kentucky and Arkansas. Data were analyzed using conventional content analysis. Results: The pandemic significantly impacted healthcare delivery. While telehealth was integrated for behavioral health counseling, in-person visits remained crucial, especially for urine drug screenings. Telehealth experiences varied, with some facing technology issues, while others found it efficient. Telehealth proved valuable for behavioral health counseling and sustaining relationships with established patients. Patients with OUD faced unique challenges, including housing, internet, transportation, and counseling needs. Stigma surrounding OUD affected clinical relationships. Building strong patient-provider relationships emerged as a central theme, emphasizing the value of face-to-face interactions. Regarding buprenorphine training, most found waiver training helpful but lacked formal education. Conclusion: This research offers vital guidance for improving OUD treatment services, especially in rural areas during crises like the COVID-19 pandemic. It highlights telehealth’s value as a tool while acknowledging its limitations. The study underscores the significance of strong patient-provider relationships, the importance of reducing stigma, and the potential for training programs to elevate quality of care in OUD treatment.

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Section: Discussionmentioning

confidence: 99%

Primary Care Providers’ Experiences Treating Opioid Use Disorder Using Telehealth in the Height of the COVID-19 Pandemic

Marshall,

Siebenmorgen,

Youngen

et al. 2024

J Prim Care Community Health

View full text Add to dashboard Cite

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“…In rural areas, additional barriers exist to provide MOUD to people who are incarcerated due in part to geographical distance to services (Mitchell et al, 2022 ) and lack of treatment providers (Bridges et al, 2023 ). Funding was also a barrier to providing MOUD identified in this study, as the rural jails were under-resourced and faced challenges of maintaining adequate staffing.…”

Section: Discussionmentioning

confidence: 99%

Facilitators and barriers to adopting or expanding medications for opioid use disorder provision in rural Colorado jails: a qualitative analysis

McNeely,

Schreiber,

Swann

et al. 2024

Health Justice

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Background Opioid use disorder (OUD) is common among individuals who are incarcerated. However, OUD treatment services are sparse in smaller county jails found in many rural areas, which limits a healthy and supportive jail environment. This study assesses the facilitators of and barriers to medications for opioid use disorder (MOUD) adoption or expansion in rural Colorado jails. A qualitative descriptive design was implemented during the summer of 2022 using semi-structured interviews with jail staff, sheriffs, and contracted personnel. Interview questions focused on facilitators of existing MOUD services and barriers to adopting or expanding services. To identify the facilitators and barriers, data were coded using thematic analysis. Results Seven jails were included in the study. Representatives from each jail participated in the seven interviews, which often included multiple participants per interview. Three of the jails had established routine practices for MOUD administration. Two jails occasionally administered MOUD or had plans in place to be able to administer, while the remaining two did not offer any MOUD. While administrative support, collaborative partnerships, and jail nurses facilitated MOUD use, barriers were more prevalent, including physical space limitations, distance to services, lack of providers in the area, staffing and training issues, funding/budget issues, and perceived risk of diversion. Conclusion Making MOUD available to people who are incarcerated is an important and timely step in enhancing the jail environment, especially in rural areas that often lack access to MOUD. As states look to require MOUD availability for people who are incarcerated, facilitators to MOUD adoption/expansion can be leveraged while strategies are needed to overcome barriers.

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Medications for opioid use disorder in rural primary care practices: Patient and provider experiences

Cited by 2 publications

References 31 publications

Primary Care Providers’ Experiences Treating Opioid Use Disorder Using Telehealth in the Height of the COVID-19 Pandemic

Primary Care Providers’ Experiences Treating Opioid Use Disorder Using Telehealth in the Height of the COVID-19 Pandemic

Facilitators and barriers to adopting or expanding medications for opioid use disorder provision in rural Colorado jails: a qualitative analysis

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