Department of Internal Medicine, University of South Florida, 17 Davis Blvd, Suite 308, Tampa, FL 33606 (BS, DL, CB, RM, AO); Department of Internal Medicine, Mount Sinai Medical Center, Miami, 4300 Alton Road, Miami Beach, FL 33140 (IU); Department of Internal Medicine, University of Central Florida College of Medicine, 6850 Lake Nona Blvd, Orlando, FL 32827 (SB, MQ).
J Addict Med. 2021;15(3):219-225. doi: 10.1097/ADM.0000000000000750.
To determine internal medicine (IM) residents' knowledge of, attitudes towards, and barriers to prescribing buprenorphine for opioid use disorder (OUD).
We conducted a cross-sectional study of IM residents across all 35 Accreditation Council for Graduate Medical Education (ACGME) accredited Florida IM residency programs. We used an online survey to collect information about resident demographics, substance use curriculums, career interests, content knowledge about diagnosing and managing OUD, and attitudes about and barriers to prescribing buprenorphine for OUD. We used Chi-square test to explore differences in interest in prescribing buprenorphine. We created a composite knowledge score and investigated distribution of knowledge among characteristics via Mann-Whitney U test.
There were 161 participants (response rate 16.0%, n = 1008) across 35 programs Seventy-seven percent of residents provided care for patients with OUD more than once per month. Seventy-four percent report no buprenorphine prescribing training. Higher knowledge scores, interest in primary care, being an intern, and caring for patients with OUD more than monthly were associated with interest in obtaining a buprenorphine waiver (P < 0.05). Limited knowledge about OUD was the most important barrier to prescribing buprenorphine. Eighty-nine percent support legislation to deregulate buprenorphine.
Knowledge about managing OUD was poor and represented the most commonly cited barrier to prescribing buprenorphine. Residents want to expand their role in treating OUD. Our findings warrant incorporating addiction medicine into residency curriculum standards. Legislation removing the buprenorphine waiver requirement may increase the number of resident buprenorphine prescribers and improve treatment options for patients with opioid addiction.
确定内科住院医师对阿片类药物使用障碍（OUD）开具丁丙诺啡的了解、态度和障碍。
我们对佛罗里达州所有 35 个经住院医师教育认证委员会（ACGME）认可的内科住院医师培训项目中的内科住院医师进行了横断面研究。我们使用在线调查收集有关住院医师人口统计学、药物使用课程、职业兴趣、诊断和管理 OUD 的内容知识以及对 OUD 开具丁丙诺啡的态度和障碍的信息。我们使用卡方检验探讨对开具丁丙诺啡的兴趣差异。我们创建了一个综合知识评分，并通过曼-惠特尼 U 检验研究了特征之间知识分布的差异。
35 个项目中有 161 名参与者（应答率 16.0%，n=1008）。77%的住院医师每月为 OUD 患者提供一次以上的治疗。74%的人报告没有丁丙诺啡处方培训。更高的知识得分、对初级保健的兴趣、作为实习医生和每月为 OUD 患者提供更多的治疗与获得丁丙诺啡豁免的兴趣相关（P<0.05）。对 OUD 的了解有限是开具丁丙诺啡的最重要障碍。89%的人支持放宽丁丙诺啡法规。
对 OUD 管理的知识很差，这是开具丁丙诺啡的最常见障碍。住院医师希望扩大他们在治疗 OUD 中的作用。我们的发现证明需要将成瘾医学纳入住院医师课程标准。取消丁丙诺啡豁免要求的立法可能会增加住院医师丁丙诺啡的处方数量，并为阿片类药物成瘾患者提供更多的治疗选择。
