Prescribe to Save Lives: Improving Buprenorphine Prescribing Among HIV Clinicians

Jawa, Raagini; Walley, Alexander Y.; Wilson, Donna; Green, Traci C.; McKenzie, Michelle; Hoskinson, Randall; Bratberg, Jeffrey; Ramsey, Susan E.; Rich, Josiah D.; Friedmann, Peter D.

doi:10.1097/qai.0000000000003001

Cited by 5 publications

(2 citation statements)

References 54 publications

(67 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another stepped wedge study in HIV clinics that looked at academic detailing and peer-to-peer education showed significant improvement in the confidence and readiness to prescribe buprenorphine in the 6-month postintervention phase followed by sustained improvement in the 12-month follow-up. There were no meaningful improvements in buprenorphine prescribing 13 …”

Section: Discussionmentioning

confidence: 91%

“…There were no meaningful improvements in buprenorphine prescribing. 13 Further research should focus on understanding the barriers to preferring onsite treatment. Our baseline formative evaluation identified difficulty with determining treatment eligible patients, variable experiences with prior medications for addiction treatment, perceived complexity of treatments, perceived need for robust behavioral services, and inconsistency in availability of trained onsite specialists as barriers.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Facilitation and Preferred Models for Delivering Substance Use Disorder Treatment in HIV Clinics: Results From a Multisite Randomized Trial

et al. 2023

View full text Add to dashboard Cite

Background: Integrated addiction treatment in HIV clinics is associated with improved outcomes, yet it is offered inconsistently and with variable models of care. We sought to evaluate the impact of Implementation Facilitation ("Facilitation") on clinician and staff preference for provision of addiction treatment in HIV clinics with on-site resources (all trained or designated on-site specialist) versus outside resources (outside specialist or refer out). Methods: From July 2017 to July 2020, surveys assessed clinician and staff preferences for addiction treatment models during control (ie, baseline), intervention, evaluation, and maintenance phases in 4 HIV clinics in the Northeast United States. Results: During the control phase, among 76 respondents (response rate, 58%), the proportions who preferred treatment with on-site resources for opioid use disorder (OUD), alcohol use disorder (AUD), and tobacco use disorder (TUD) were 63%, 55%, and 63%, respectively. Compared with control, there were no significant differences in preferred model during the intervention and evaluation phases except for AUD where there was an increased preference for treatment with on-site resources in the intervention versus control phase. Compared with control, during the maintenance phase, a higher proportion of clinicians and staff preferred providing addiction treatment with on-site resources versus outside resources: OUD, 75% (odds ratio [OR; 95% confidence interval {CI}],1.79 [1.06-3.03]); AUD, 73% (OR [95% CI], 2.23 [1.36-3.65]), and TUD, 76% (OR [95% CI], 1. 88 [1.11-3.18]). Conclusions: The findings from this study lend support for "Facilitation" as a strategy to enhance clinician and staff preference for integrated addiction treatment in HIV clinics with on-site resources.

show abstract

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Facilitation and Preferred Models for Delivering Substance Use Disorder Treatment in HIV Clinics: Results From a Multisite Randomized Trial

et al. 2023

View full text Add to dashboard Cite

show abstract

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

Fujita

Loughry

Moore

et al. 2022

Clinical Infectious Diseases

View full text Add to dashboard Cite

Background Persons with opioid use disorder (OUD) may present with infectious complications from injection drug use, thus 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 November 1, 2021 to January 15, 2022. Our primary outcome was 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 geographic distribution of waivered ID physicians. Results We identified 6372 ID physicians in the US, 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 0.79, 95% CI 0.68-0.91). ID physicians practicing in counties with higher proportion of uninsured residents had lower odds of having a waiver (OR 0.75, 95% CI 0.62-0.90). Among counties with at least one ID physician (n = 729), only 11.2% had at least one 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.

show abstract

Meeting the Moment: More Infectious Disease Physicians Must Be Prepared to Provide Buprenorphine

Harvey

Kimmel

Edelman

2023

Clinical Infectious Diseases

View full text Add to dashboard Cite

Prescribe to Save Lives: Improving Buprenorphine Prescribing Among HIV Clinicians

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 5 publications

References 54 publications

Facilitation and Preferred Models for Delivering Substance Use Disorder Treatment in HIV Clinics: Results From a Multisite Randomized Trial

Facilitation and Preferred Models for Delivering Substance Use Disorder Treatment in HIV Clinics: Results From a Multisite Randomized Trial

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

Meeting the Moment: More Infectious Disease Physicians Must Be Prepared to Provide Buprenorphine

Contact Info

Product

Resources

About