Ohio University Heritage College of Osteopathic Medicine, Department of Social Medicine, Ohio University Athens, Heritage Hall 1, Athens, OH, 45701-2979, USA.
Appalachian Institute to Advance Health Equity Science, Athens, OH, USA.
Addict Sci Clin Pract. 2024 Jan 19;19(1):7. doi: 10.1186/s13722-024-00436-y.
Buprenorphine is a highly effective medication for opioid use disorder that is underused by health care professionals (HCPs). Medications for opioid use disorder (MOUD) misinformation may be an important barrier to buprenorphine access, but most implementation strategies have aimed to reduce negative attitudes towards patients with opioid use disorder (OUD) rather than misinformation specific to buprenorphine use. In this study, we assessed the degree to which HCPs endorsed misinformation related to buprenorphine, and whether this is associated with willingness to provide care to patients with OUD.
In September-December of 2022, we surveyed HCPs practicing in Ohio (n = 409). Our primary outcomes included a previously validated 5-item measure of HCP willingness to treat patients with OUD, and three other measures of willingness. Our key independent variable was a study-developed 5-item measure of endorsement of misinformation related to buprenorphine, which assessed beliefs in buprenorphine's efficacy in managing withdrawal symptoms and reducing overdose deaths as well as beliefs about the role of buprenorphine in achieving remission. We computed descriptive and bivariable statistics and fit regression models predicting each outcome of interest.
On average, HCPs scored 2.34 out of 5.00 (SD = 0.80) on the composite measure of buprenorphine misinformation. 48.41% of participants endorsed at least one piece of misinformation. The most endorsed items were that buprenorphine is ineffective at reducing overdose deaths (M = 2.75, SD =0 .98), and that its use substitutes one drug for another (M = 2.41, SD = 1.25). HCP endorsement of buprenorphine misinformation significantly and negatively predicted willingness to work with patients with OUD (b = - 0.34; 95% CI - 0.46, - 0.21); intentions to increase time spent with this patient population (b = - 0.36; 95% CI - 5.86, - 1.28); receipt of an X-waiver (OR = 0.54, 95% CI 0.38, 0.77); and intention to get an X-waiver (OR: 0.56; 95% CI: 0.33-0.94).
Misinformation is common among HCPs and associated with lower willingness to treat patients with OUD. Implementation strategies to increase MOUD use among HCPs should specifically counter misinformation related to buprenorphine.
Clinicaltrials.gov, NCT05505227. Registered 17 August 2022, https://clinicaltrials.gov/ct2/show/NCT05505227.
丁丙诺啡是一种治疗阿片类药物使用障碍的高效药物，但医疗保健专业人员（HCP）对其的使用不足。阿片类药物使用障碍（MOUD）的错误信息可能是获得丁丙诺啡的一个重要障碍，但大多数实施策略旨在减少对阿片类药物使用障碍（OUD）患者的负面态度，而不是针对丁丙诺啡使用的错误信息。在这项研究中，我们评估了 HCP 对与丁丙诺啡相关的错误信息的认可程度，以及这是否与为 OUD 患者提供护理的意愿有关。
在 2022 年 9 月至 12 月期间，我们调查了俄亥俄州的 HCP（n=409）。我们的主要结果包括以前验证过的 5 项衡量 HCP 治疗 OUD 患者意愿的措施，以及其他 3 项衡量意愿的措施。我们的关键自变量是一项研究开发的 5 项衡量对与丁丙诺啡相关的错误信息的认可程度的措施，该措施评估了丁丙诺啡在管理戒断症状和减少过量死亡方面的疗效以及在实现缓解方面的作用。我们计算了描述性和双变量统计数据，并拟合了预测每个感兴趣结果的回归模型。
平均而言，HCP 在丁丙诺啡错误信息综合衡量指标上得分为 2.34 分（满分 5.00 分，标准差 0.80）。48.41%的参与者认可至少一项错误信息。最受认可的项目是丁丙诺啡不能有效降低过量死亡的风险（M=2.75，SD=0 ），以及它的使用替代了另一种药物（M=2.41，SD=1.25）。HCP 对丁丙诺啡错误信息的认可程度显著且负相关于治疗 OUD 患者的意愿（b=-0.34；95%置信区间 -0.46，-0.21）；增加与该患者群体接触时间的意愿（b=-0.36；95%置信区间 -5.86，-1.28）；获得 X 豁免（OR=0.54，95%置信区间 0.38，0.77）；以及获得 X 豁免的意愿（OR：0.56；95%置信区间：0.33-0.94）。
错误信息在 HCP 中很常见，并且与治疗 OUD 患者的意愿降低有关。增加 HCP 中 MOUD 使用的实施策略应专门针对与丁丙诺啡相关的错误信息。
Clinicaltrials.gov，NCT05505227。于 2022 年 8 月 17 日注册，https://clinicaltrials.gov/ct2/show/NCT05505227。
