From the Department of Family Medicine, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill (VB, CGW, EBF, KBF); UNC Health Sciences at MAHEC, Asheville, NC (CGW, EBF, CRT); Division of Practice Advancement and Clinical Education, Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill (CGW); Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC (JK); Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, NC (CRT).
From the Department of Family Medicine, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill (VB, CGW, EBF, KBF); UNC Health Sciences at MAHEC, Asheville, NC (CGW, EBF, CRT); Division of Practice Advancement and Clinical Education, Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill (CGW); Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC (JK); Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, NC (CRT)
J Am Board Fam Med. 2020 Nov-Dec;33(6):998-1003. doi: 10.3122/jabfm.2020.06.200127.
Family medicine residency programs vary in the extent of training offered on opioid use disorder (OUD) in their curricula. The purpose of this study was to determine the impact of OUD education and buprenorphine waiver provision on postresidency buprenorphine prescribing patterns.
Three North Carolina family medicine residency programs differed in the extent to which they taught OUD, including buprenorphine waiver provision. Program A required OUD education and assisted residents in obtaining a waiver; Program B offered OUD education and did not assist with obtaining a waiver; and Program C did not offer OUD education. In November 2019, graduates from these 3 programs were surveyed regarding the extent to which they engaged in treatment of OUD. Descriptive statistics were used to characterize the survey participants and their responses.
Of the 62 graduates invited to participate, 49 (79.0%) responded. Across the 3 programs, the percentage of graduates with a waiver varied significantly ( < .0001): Program A (84.2%), Program B (33.3%), and Program C (0.0%). Of those who were not waivered, Program B had a larger percentage that desired to prescribe buprenorphine products (70.0%) as compared with Program C (9.1%) ( = .009).
Family medicine residency graduates from programs with more integrated OUD education were more likely to obtain and use a waiver to prescribe buprenorphine-containing medications postgraduation.
家庭医学住院医师培训项目在课程中提供的阿片类药物使用障碍(OUD)培训程度各有不同。本研究的目的是确定 OUD 教育和丁丙诺啡豁免规定对毕业后丁丙诺啡处方模式的影响。
北卡罗来纳州的三个家庭医学住院医师培训项目在 OUD 教学方面存在差异,包括丁丙诺啡豁免规定。项目 A 要求 OUD 教育并协助居民获得豁免;项目 B 提供 OUD 教育,但不协助获得豁免;项目 C 不提供 OUD 教育。2019 年 11 月,对这三个项目的毕业生进行了调查,了解他们在治疗 OUD 方面的参与程度。采用描述性统计方法对调查参与者及其回答进行描述。
在邀请参加的 62 名毕业生中,有 49 名(79.0%)做出了回应。在这三个项目中,获得豁免的毕业生比例存在显著差异( < .0001):项目 A(84.2%)、项目 B(33.3%)和项目 C(0.0%)。在没有获得豁免的人中,项目 B 中有更大比例的人希望开丁丙诺啡产品(70.0%),而项目 C 则为 9.1%( = .009)。
接受过更综合 OUD 教育的家庭医学住院医师培训项目的毕业生更有可能获得并使用豁免权,以便毕业后开含有丁丙诺啡的药物。