Lello Tesema1, Jeffrey Marshall2, Rachel Hathaway3, Christina Pham4, Camille Clarke5, Genevieve Bergeron3, James Yeh6, Michael Soliman7, Danny McCormick3. 1. a Los Angeles County Department of Health Services , Los Angeles , California , USA. 2. b Department of Pulmonary and Critical Care Medicine , Yale University , New Haven , Connecticut , USA. 3. c Department of Medicine , Cambridge Health Alliance , Cambridge , Massachusetts , USA. 4. d Department of Medicine , University of California , San Francisco , California , USA. 5. e Department of Medicine, School of Medicine , Loma Linda University , Loma Linda , California , USA. 6. f Department of Medicine , Brigham and Women's Hospital , Boston , Massachusetts , USA. 7. g Department of Medicine , Beth Israel Deaconess Medical Center , Boston , Massachusetts , USA.
Abstract
BACKGROUND: The prevalence of opioid use disorder (OUD) has increased sharply. Office-based opioid treatment with buprenorphine (OBOT) is effective but often underutilized because of physicians' lack of experience prescribing this therapy. Little is known about US residency training programs' provision of OBOT and addiction medicine training. METHODS: The authors conducted a survey of residency program directors (RPDs) at all US residency programs in internal medicine, family medicine, and psychiatry to assess the frequency with which their residents provide care for OUD, presence and features of curricula in OBOT and addiction medicine, RPDs' beliefs about OBOT, and potential barriers to providing OBOT training. RESULTS: The response rate was 49.5% (476 of 962). Although 76.9% of RPDs reported that residents frequently manage patients with OUD, only 23.5% reported that their program dedicates 12 or more hours of curricular time to addiction medicine, 35.9% reported that their program encourages/requires training in OBOT, and 22.6% reported that their program encourages/requires obtaining a Drug Enforcement Administration (DEA) waiver to prescribe buprenorphine. Most RPDs believe that OBOT is an important treatment option for OUD (88.1%) and that increased residency training in OBOT would improve access to OBOT (73.7%). The authors also found that programs whose RPD had favorable views of OBOT were more likely to provide OBOT and addiction medicine training. Psychiatry programs were most likely to provide OBOT training and their RPDs most likely to have beliefs about OBOT that were positive. Commonly cited barriers to implementing OBOT training include a lack of waivered preceptors (76.9%), competing curricular priorities (64.1%), and a lack of support (social work and counseling) services (54.0%). CONCLUSIONS: Internal medicine, family medicine, and psychiatry residents often care for patients with OUD, and most RPDs believe that increased residency training in OBOT would increase access to this treatment. Yet, only a minority of programs offer training in OBOT.
BACKGROUND: The prevalence of opioid use disorder (OUD) has increased sharply. Office-based opioid treatment with buprenorphine (OBOT) is effective but often underutilized because of physicians' lack of experience prescribing this therapy. Little is known about US residency training programs' provision of OBOT and addiction medicine training. METHODS: The authors conducted a survey of residency program directors (RPDs) at all US residency programs in internal medicine, family medicine, and psychiatry to assess the frequency with which their residents provide care for OUD, presence and features of curricula in OBOT and addiction medicine, RPDs' beliefs about OBOT, and potential barriers to providing OBOT training. RESULTS: The response rate was 49.5% (476 of 962). Although 76.9% of RPDs reported that residents frequently manage patients with OUD, only 23.5% reported that their program dedicates 12 or more hours of curricular time to addiction medicine, 35.9% reported that their program encourages/requires training in OBOT, and 22.6% reported that their program encourages/requires obtaining a Drug Enforcement Administration (DEA) waiver to prescribe buprenorphine. Most RPDs believe that OBOT is an important treatment option for OUD (88.1%) and that increased residency training in OBOT would improve access to OBOT (73.7%). The authors also found that programs whose RPD had favorable views of OBOT were more likely to provide OBOT and addiction medicine training. Psychiatry programs were most likely to provide OBOT training and their RPDs most likely to have beliefs about OBOT that were positive. Commonly cited barriers to implementing OBOT training include a lack of waivered preceptors (76.9%), competing curricular priorities (64.1%), and a lack of support (social work and counseling) services (54.0%). CONCLUSIONS: Internal medicine, family medicine, and psychiatry residents often care for patients with OUD, and most RPDs believe that increased residency training in OBOT would increase access to this treatment. Yet, only a minority of programs offer training in OBOT.
Authors: Tamara Beetham; Brendan Saloner; Sarah E Wakeman; Marema Gaye; Michael L Barnett Journal: Ann Intern Med Date: 2019-06-04 Impact factor: 25.391
Authors: Alene Kennedy-Hendricks; Colleen L Barry; Elizabeth Stone; Marcus A Bachhuber; Emma E McGinty Journal: Drug Alcohol Depend Date: 2020-08-06 Impact factor: 4.492
Authors: Sarah Sweeney; Kelly Coble; Elizabeth Connors; Kathleen Rebbert-Franklin; Christopher Welsh; Eric Weintraub Journal: Subst Abus Date: 2020-08-19 Impact factor: 3.716
Authors: Julienne K Kirk; Tamela Yount; Charlotte T Boyd; Lisa Cassidy-Vu; Aubry N Koehler; John G Spangler Journal: J Prim Care Community Health Date: 2020 Jan-Dec
Authors: Gabriela Garcia-Vassallo; Ellen Lockard Edens; Brady Heward; Marc A Auerbach; Ambrose H Wong; Deepa Camenga Journal: MedEdPORTAL Date: 2021-04-20
Authors: Delia Motavalli; Jessica L Taylor; Ellen Childs; Pablo K Valente; Peter Salhaney; Jennifer Olson; Dea L Biancarelli; Alberto Edeza; Joel J Earlywine; Brandon D L Marshall; Mari-Lynn Drainoni; Matthew J Mimiaga; Katie B Biello; Angela R Bazzi Journal: J Gen Intern Med Date: 2020-09-11 Impact factor: 5.128