John Samuel, Boorman David W, Potru Sudheer
From the Department of Social, Behavioral, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA (SJ); Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA (DWB); Atlanta VA Healthcare System, Atlanta, GA (SP); Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA (SP).
J Addict Med. 2023;17(2):e94-e100. doi: 10.1097/ADM.0000000000001066. Epub 2022 Aug 24.
The aim of the study is to investigate barriers to opioid use disorder (OUD) care among acute and chronic pain physicians and advanced practice providers, including hypothesized barriers of lack of interest in OUD care and stigma toward this patient population.
The study used an anonymous 16-item online survey through Google Forms. Respondents were 153 health practitioners across the United States and Canada, all of whom are registered in one of several pain or anesthesia professional societies. Data were analyzed with descriptive and categorical statistics.
The most common barriers include "lack of appropriate clinical environment for prescribing by both acute and chronic pain practitioners" (48%) and "lack of administrative/departmental support" (46%). A total of 32% of respondents reported that OUD care was important but they were not interested in doing more, while 28% of practitioners believed that they treat patients with OUD differently than others in a negative way. More males reported "difficulty" in treating OUD as a barrier (45% vs 25%). Chronic pain practitioners reported poor payor mix as a barrier twice as often as their acute pain colleagues. In free response, lack of multidisciplinary OUD care was a notable barrier.
The top barriers to OUD treatment were clinical environment, departmental support, difficulty in treating the condition, and payor mix, supporting the hypotheses. Given an OUD patient scenario, 55% of acute pain physicians and 73% of chronic pain physicians expressed a willingness to prescribe buprenorphine.
本研究旨在调查急性和慢性疼痛科医生以及高级执业人员在阿片类物质使用障碍（OUD）护理方面的障碍，包括假设的对OUD护理缺乏兴趣以及对该患者群体的污名化等障碍。
该研究通过谷歌表单进行了一项包含16个项目的匿名在线调查。受访者为美国和加拿大的153名医疗从业者，他们均在几个疼痛或麻醉专业协会中的一个进行了注册。数据采用描述性和分类统计方法进行分析。
最常见的障碍包括“急性和慢性疼痛从业者都缺乏合适的处方临床环境”（48%）以及“缺乏行政/部门支持”（46%）。共有32%的受访者表示OUD护理很重要，但他们对做得更多不感兴趣，而28%的从业者认为他们以负面方式区别对待患有OUD的患者。更多男性报告称将治疗OUD的“困难”视为障碍（45%对25%）。慢性疼痛从业者将支付方组合不佳视为障碍的频率是急性疼痛同行的两倍。在自由作答中，缺乏多学科的OUD护理是一个显著障碍。
OUD治疗的首要障碍是临床环境、部门支持、治疗该病的困难以及支付方组合，这支持了假设。在给定一个OUD患者的情况下，55%的急性疼痛科医生和73%的慢性疼痛科医生表示愿意开具丁丙诺啡。
