Buprenorphine misinformation and willingness to treat patients with opioid use disorder among primary care-aligned health care professionals.

IF 3.7 2区医学 Q1 SUBSTANCE ABUSE Addiction Science & Clinical Practice Pub Date : 2024-01-19 DOI:10.1186/s13722-024-00436-y

Berkeley Franz, Lindsay Y Dhanani, O Trent Hall, Daniel L Brook, Cheyenne Fenstemaker, Janet E Simon, William C Miller

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Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

Clinical trial registration: Clinicaltrials.gov, NCT05505227. Registered 17 August 2022, https://clinicaltrials.gov/ct2/show/NCT05505227.

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丁丙诺啡的错误信息与初级保健对口医护人员治疗阿片类药物使用障碍患者的意愿。

背景：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（HCPs）对其使用不足。治疗阿片类药物使用障碍（MOUD）的错误信息可能是丁丙诺啡使用的一个重要障碍，但大多数实施策略都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，我们评估了初级保健人员认可与丁丙诺啡有关的错误信息的程度，以及这是否与向 OUD 患者提供护理的意愿有关：2022 年 9 月至 12 月，我们对俄亥俄州的执业医师进行了调查（n = 409）。我们的主要结果包括一个先前经过验证的衡量 HCP 治疗 OUD 患者意愿的 5 个项目，以及其他三个衡量意愿的项目。我们的关键自变量是一项研究开发的关于丁丙诺啡相关错误信息认可度的 5 项测量，它评估了对丁丙诺啡在控制戒断症状和减少过量用药死亡方面疗效的信念，以及对丁丙诺啡在实现缓解方面作用的信念。我们计算了描述性统计和双变量统计，并拟合了预测每个相关结果的回归模型：在关于丁丙诺啡错误信息的综合测量中，HCP 的平均得分为 2.34（满分 5.00）（SD = 0.80）。48.41%的参与者认可至少一项错误信息。认可最多的项目是：丁丙诺啡不能有效减少用药过量死亡（M = 2.75，SD = 0.98），以及使用丁丙诺啡会以一种药物替代另一种药物（M = 2.41，SD = 1.25）。HCP 对丁丙诺啡误导信息的认可度会显著消极地预测与 OUD 患者合作的意愿（b = - 0.34; 95% CI - 0.46, - 0.21）；增加与该患者群体接触时间的意愿（b = - 0.36；95% CI - 5.86, - 1.28）；获得 X 豁免的意愿（OR = 0.54，95% CI 0.38, 0.77）；以及获得 X 豁免的意愿（OR：0.56；95% CI：0.33-0.94）：结论：错误信息在保健医生中很常见，并且与治疗 OUD 患者的意愿较低有关。为提高医护人员对 MOUD 的使用率，实施策略应特别针对与丁丙诺啡有关的错误信息：临床试验注册：Clinicaltrials.gov，NCT05505227。注册日期：2022 年 8 月 17 日，https://clinicaltrials.gov/ct2/show/NCT05505227。

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来源期刊

Addiction Science & Clinical Practice Psychology-Clinical Psychology

CiteScore

3.90

自引率

10.80%

发文量

审稿时长

28 weeks

期刊介绍： Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings. Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use. Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations. Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.