Center for Health Policy and Healthcare Research, Northeastern University, Boston, MA, USA.
Bouve College of Health Sciences, Northeastern University, Boston, MA, USA.
Addict Sci Clin Pract. 2024 Nov 21;19(1):85. doi: 10.1186/s13722-024-00516-z.
Opioid use disorder (OUD) remains a significant public health issue as the number of opioid-related overdose deaths continues to reach new highs each year. Buprenorphine/Naloxone is a medication that has been shown to be highly effective for the treatment of OUD. However, the clinical management of patients on this medication is challenging as many patients discontinue treatment prematurely. We conducted a qualitative study focusing on experienced prescribers of buprenorphine to learn about what they believe are key challenges in prescribing this medication to patients with OUD and related strategies for improving treatment outcomes.
We conducted two rounds of interviews with 12 prescribers who were either trained as a primary care physician, nurse practitioner, or physician assistant. These prescribers were recruited from an academically-based treatment program, a community health center, and a commercial substance use disorder treatment facility. Interview data were coded and analyzed in accordance with a grounded theory approach.
Key findings and related recommendations emerged for patient monitoring, integration of behavioral health with prescribing, patient volume requirements, and use of telehealth.
The interviews generated a number of recommendations for improving patient outcomes from buprenorphine treatment. Some of these recommendations can be implemented quite readily whereas others entail more substantial resources and time commitments.
阿片类药物使用障碍(OUD)仍然是一个重大的公共卫生问题,因为每年与阿片类药物相关的过量死亡人数持续达到新高。丁丙诺啡/纳洛酮是一种已被证明对治疗 OUD 非常有效的药物。然而,由于许多患者过早停止治疗,因此对接受这种药物治疗的患者进行临床管理具有挑战性。我们进行了一项定性研究,重点关注丁丙诺啡的经验丰富的处方医生,以了解他们认为在为 OUD 患者开这种药物方面存在哪些关键挑战,以及改善治疗效果的相关策略。
我们对 12 名接受过初级保健医生、护士从业者或医师助理培训的处方医生进行了两轮访谈。这些处方医生是从一个基于学术的治疗项目、一个社区卫生中心和一个商业物质使用障碍治疗机构招募的。根据扎根理论方法对访谈数据进行编码和分析。
在患者监测、行为健康与处方整合、患者数量要求和使用远程医疗方面出现了关键发现和相关建议。
访谈提出了许多关于改善丁丙诺啡治疗患者结局的建议。其中一些建议可以很快实施,而其他建议则需要更多的资源和时间投入。