Russell Holly Ann, Smith Brian, Sanders Mechelle, Loomis Elizabeth
Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, United States.
University of Rochester School of Nursing, Rochester, NY, United States.
Front Psychiatry. 2021 Aug 2;12:639826. doi: 10.3389/fpsyt.2021.639826. eCollection 2021.
Substance use disorders remain highly stigmatized. Access to medications for opioid use disorder is poor. There are many barriers to expanding access including stigma and lack of medical education about substance use disorders. We enriched the existing, federally required, training for clinicians to prescribe buprenorphine with a biopsychosocial focus in order to decrease stigma and expand access to medications for opioid use disorder. We trained a family medicine team to deliver an enriched version of the existing buprenorphine waiver curriculum. The waiver training was integrated into the curriculum for all University of Rochester physician and nurse practitioner family medicine residents and also offered to University of Rochester residents and faculty in other disciplines and regionally. We used the Brief Substance Abuse Attitudes Survey to collect baseline and post-training data. 140 training participants completed attitude surveys. The overall attitude score increased significantly from pre to post-training. Additionally, significant changes were observed in non-moralism from pre-training ( = 20.07) to post-training ( = 20.98, < 0.001); treatment optimism from pre-training ( = 21.56) to post-training ( = 22.33, < 0.001); and treatment interventions from pre-training ( = 31.03) to post-training ( = 32.10, < 0.001). Increasing medical education around Opioid Use Disorder using a Family Medicine trained team with a biopsychosocial focus can improve provider attitudes around substance use disorders. Enriching training with cases may improve treatment optimism and may help overcome the documented barriers to prescribing medications for opioid use disorder and increase access for patients to lifesaving treatments.
物质使用障碍仍然备受污名化。阿片类物质使用障碍药物的可及性很差。扩大可及性存在许多障碍，包括污名以及缺乏关于物质使用障碍的医学教育。我们丰富了现有的、联邦要求的针对临床医生开具丁丙诺啡的培训，重点关注生物心理社会因素，以减少污名并扩大阿片类物质使用障碍药物的可及性。我们培训了一个家庭医学团队来提供现有丁丙诺啡豁免课程的强化版本。该豁免培训被纳入罗切斯特大学所有家庭医学住院医师（医生和执业护士）的课程中，也提供给罗切斯特大学其他学科的住院医师和教职员工以及其他地区的人员。我们使用简短物质滥用态度调查来收集培训前和培训后的数据。140名培训参与者完成了态度调查。培训前后总体态度得分显著提高。此外，观察到从培训前（=20.07）到培训后（=20.98，<0.001）非道德主义有显著变化；从培训前（=21.56）到培训后（=22.33，<0.001）治疗乐观主义有显著变化；从培训前（=31.03）到培训后（=32.10，<0.001）治疗干预有显著变化。使用以生物心理社会为重点的家庭医学培训团队增加围绕阿片类物质使用障碍的医学教育，可以改善医疗服务提供者对物质使用障碍的态度。用案例丰富培训可能会提高治疗乐观主义，并可能有助于克服已记录的开具阿片类物质使用障碍药物的障碍，增加患者获得救命治疗的机会。
