Barriers to obtaining waivers to prescribe buprenorphine for opioid addiction treatment among HIV physicians
Illicit drug use is common among HIV-infected individuals. Buprenorphine enables physicians to simultaneously treat HIV and opioid dependence, offering opportunities to improve health outcomes. Despite this, few physicians prescribe buprenorphine. To examine barriers to obtaining waivers to prescrib...
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| Veröffentlicht in: | Journal of general internal medicine : JGIM 2007-09, Vol.22 (9), p.1325-1329 |
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| creator | CUNNINGHAM, Chinazo O KUNINS, Hillary V ROOSE, Robert J ELAM, Rashiah T SOHLER, Nancy L |
| description | Illicit drug use is common among HIV-infected individuals. Buprenorphine enables physicians to simultaneously treat HIV and opioid dependence, offering opportunities to improve health outcomes. Despite this, few physicians prescribe buprenorphine.
To examine barriers to obtaining waivers to prescribe buprenorphine.
Cross-sectional survey study.
375 physicians attending HIV educational conferences in six cities in 2006.
Anonymous questionnaires were distributed and analyzed to test whether confidence addressing drug problems and perceived barriers to prescribing buprenorphine were associated with having a buprenorphine waiver, using chi-square, t tests, and logistic regression.
25.1% of HIV physicians had waivers to prescribe buprenorphine. In bivariate analyses, physicians with waivers versus those without waivers were less likely to be male (51.1 vs 63.7%, p < .05), more likely to be in New York (51.1 vs 29.5%, p < .01), less likely to be infectious disease specialists (25.5 vs 41.6%, p < .05), and more likely to be general internists (43.6 vs 33.5%, p < .05). Adjusting for physician characteristics, confidence addressing drug problems (adjusted odds ratio [AOR] = 2.05, 95% confidence interval [95% CI] = 1.08-3.88) and concern about lack of access to addiction experts (AOR = 0.56, 95% CI = 0.32-0.97) were significantly associated with having a buprenorphine waiver.
Among HIV physicians attending educational conferences, confidence addressing drug problems was positively associated with having a buprenorphine waiver, and concern about lack of access to addiction experts was negatively associated with it. HIV physicians are uniquely positioned to provide opioid addiction treatment in the HIV primary care setting. Understanding and remediating barriers HIV physicians face may lead to new opportunities to improve outcomes for opioid-dependent HIV-infected patients. |
| doi_str_mv | 10.1007/s11606-007-0264-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2219773</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2395711461</sourcerecordid><originalsourceid>FETCH-LOGICAL-c454t-fb410ebaa4d47643308258549d0a4aea44c423cbf6923ff74dbe0ce0394544813</originalsourceid><addsrcrecordid>eNpVkU1rGzEYhEVJaRy3P6CXIAI9bqqPd1e7l0AS2sRg6KXJVbyr1doKtrSR1in-95XxUqcnDdIzo4Eh5Ctn15wx9T1xXrGqyLJgooJCfSAzXoqy4NCoMzJjdQ1FrSSck4uUXhjjUoj6EznnquJNI2FGNncYo7Mx0THQ0I7ovPMr-gfd23Q5RJtMdK2l7S5rH-Kwdt7SPkQaBhdcR7HrnBld8HSMFset9SPFbcg5j4tnOqz3yRmHPn0mH3vcJPtlOufk6eeP3_ePxfLXw-L-dlkYKGEs-hY4sy0idKAqkJLVoqxLaDqGgBYBDAhp2r5qhOx7BV1rmbFMNtkONZdzcnPMHXbt1nYm94m40UN0W4x7HdDp_1-8W-tVeNNC8EYpmQOupoAYXnc2jfol7KLPnXWtSgVKlWWG-BEyMaQUbf_vA870YR993Ecf5GEfrbLn8n2zk2MaJAPfJgCTwU0f0RuXTlzDgEkp5F83FZsO</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>875747755</pqid></control><display><type>article</type><title>Barriers to obtaining waivers to prescribe buprenorphine for opioid addiction treatment among HIV physicians</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>CUNNINGHAM, Chinazo O ; KUNINS, Hillary V ; ROOSE, Robert J ; ELAM, Rashiah T ; SOHLER, Nancy L</creator><creatorcontrib>CUNNINGHAM, Chinazo O ; KUNINS, Hillary V ; ROOSE, Robert J ; ELAM, Rashiah T ; SOHLER, Nancy L</creatorcontrib><description>Illicit drug use is common among HIV-infected individuals. Buprenorphine enables physicians to simultaneously treat HIV and opioid dependence, offering opportunities to improve health outcomes. Despite this, few physicians prescribe buprenorphine.
To examine barriers to obtaining waivers to prescribe buprenorphine.
Cross-sectional survey study.
375 physicians attending HIV educational conferences in six cities in 2006.
Anonymous questionnaires were distributed and analyzed to test whether confidence addressing drug problems and perceived barriers to prescribing buprenorphine were associated with having a buprenorphine waiver, using chi-square, t tests, and logistic regression.
25.1% of HIV physicians had waivers to prescribe buprenorphine. In bivariate analyses, physicians with waivers versus those without waivers were less likely to be male (51.1 vs 63.7%, p < .05), more likely to be in New York (51.1 vs 29.5%, p < .01), less likely to be infectious disease specialists (25.5 vs 41.6%, p < .05), and more likely to be general internists (43.6 vs 33.5%, p < .05). Adjusting for physician characteristics, confidence addressing drug problems (adjusted odds ratio [AOR] = 2.05, 95% confidence interval [95% CI] = 1.08-3.88) and concern about lack of access to addiction experts (AOR = 0.56, 95% CI = 0.32-0.97) were significantly associated with having a buprenorphine waiver.
Among HIV physicians attending educational conferences, confidence addressing drug problems was positively associated with having a buprenorphine waiver, and concern about lack of access to addiction experts was negatively associated with it. HIV physicians are uniquely positioned to provide opioid addiction treatment in the HIV primary care setting. Understanding and remediating barriers HIV physicians face may lead to new opportunities to improve outcomes for opioid-dependent HIV-infected patients.</description><identifier>ISSN: 0884-8734</identifier><identifier>EISSN: 1525-1497</identifier><identifier>DOI: 10.1007/s11606-007-0264-7</identifier><identifier>PMID: 17619934</identifier><language>eng</language><publisher>Heidelberg: Springer</publisher><subject>Addictive behaviors ; Adult ; Adult and adolescent clinical studies ; Biological and medical sciences ; Buprenorphine - therapeutic use ; Cross-Sectional Studies ; Drug addiction ; Drug and Narcotic Control ; Drug Prescriptions ; Female ; General aspects ; HIV ; HIV Infections - complications ; HIV Infections - drug therapy ; Human immunodeficiency virus ; Humans ; Internal medicine ; Male ; Medical sciences ; Middle Aged ; Miscellaneous ; Narcotics ; Opioid-Related Disorders - complications ; Opioid-Related Disorders - drug therapy ; Physicians ; Populations at Risk ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Substance abuse treatment ; Waivers</subject><ispartof>Journal of general internal medicine : JGIM, 2007-09, Vol.22 (9), p.1325-1329</ispartof><rights>2008 INIST-CNRS</rights><rights>Society of General Internal Medicine 2007</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c454t-fb410ebaa4d47643308258549d0a4aea44c423cbf6923ff74dbe0ce0394544813</citedby><cites>FETCH-LOGICAL-c454t-fb410ebaa4d47643308258549d0a4aea44c423cbf6923ff74dbe0ce0394544813</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2219773/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2219773/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19040332$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17619934$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CUNNINGHAM, Chinazo O</creatorcontrib><creatorcontrib>KUNINS, Hillary V</creatorcontrib><creatorcontrib>ROOSE, Robert J</creatorcontrib><creatorcontrib>ELAM, Rashiah T</creatorcontrib><creatorcontrib>SOHLER, Nancy L</creatorcontrib><title>Barriers to obtaining waivers to prescribe buprenorphine for opioid addiction treatment among HIV physicians</title><title>Journal of general internal medicine : JGIM</title><addtitle>J Gen Intern Med</addtitle><description>Illicit drug use is common among HIV-infected individuals. Buprenorphine enables physicians to simultaneously treat HIV and opioid dependence, offering opportunities to improve health outcomes. Despite this, few physicians prescribe buprenorphine.
To examine barriers to obtaining waivers to prescribe buprenorphine.
Cross-sectional survey study.
375 physicians attending HIV educational conferences in six cities in 2006.
Anonymous questionnaires were distributed and analyzed to test whether confidence addressing drug problems and perceived barriers to prescribing buprenorphine were associated with having a buprenorphine waiver, using chi-square, t tests, and logistic regression.
25.1% of HIV physicians had waivers to prescribe buprenorphine. In bivariate analyses, physicians with waivers versus those without waivers were less likely to be male (51.1 vs 63.7%, p < .05), more likely to be in New York (51.1 vs 29.5%, p < .01), less likely to be infectious disease specialists (25.5 vs 41.6%, p < .05), and more likely to be general internists (43.6 vs 33.5%, p < .05). Adjusting for physician characteristics, confidence addressing drug problems (adjusted odds ratio [AOR] = 2.05, 95% confidence interval [95% CI] = 1.08-3.88) and concern about lack of access to addiction experts (AOR = 0.56, 95% CI = 0.32-0.97) were significantly associated with having a buprenorphine waiver.
Among HIV physicians attending educational conferences, confidence addressing drug problems was positively associated with having a buprenorphine waiver, and concern about lack of access to addiction experts was negatively associated with it. HIV physicians are uniquely positioned to provide opioid addiction treatment in the HIV primary care setting. Understanding and remediating barriers HIV physicians face may lead to new opportunities to improve outcomes for opioid-dependent HIV-infected patients.</description><subject>Addictive behaviors</subject><subject>Adult</subject><subject>Adult and adolescent clinical studies</subject><subject>Biological and medical sciences</subject><subject>Buprenorphine - therapeutic use</subject><subject>Cross-Sectional Studies</subject><subject>Drug addiction</subject><subject>Drug and Narcotic Control</subject><subject>Drug Prescriptions</subject><subject>Female</subject><subject>General aspects</subject><subject>HIV</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - drug therapy</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Internal medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Narcotics</subject><subject>Opioid-Related Disorders - complications</subject><subject>Opioid-Related Disorders - drug therapy</subject><subject>Physicians</subject><subject>Populations at Risk</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Public health. Hygiene</subject><subject>Public health. 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Buprenorphine enables physicians to simultaneously treat HIV and opioid dependence, offering opportunities to improve health outcomes. Despite this, few physicians prescribe buprenorphine.
To examine barriers to obtaining waivers to prescribe buprenorphine.
Cross-sectional survey study.
375 physicians attending HIV educational conferences in six cities in 2006.
Anonymous questionnaires were distributed and analyzed to test whether confidence addressing drug problems and perceived barriers to prescribing buprenorphine were associated with having a buprenorphine waiver, using chi-square, t tests, and logistic regression.
25.1% of HIV physicians had waivers to prescribe buprenorphine. In bivariate analyses, physicians with waivers versus those without waivers were less likely to be male (51.1 vs 63.7%, p < .05), more likely to be in New York (51.1 vs 29.5%, p < .01), less likely to be infectious disease specialists (25.5 vs 41.6%, p < .05), and more likely to be general internists (43.6 vs 33.5%, p < .05). Adjusting for physician characteristics, confidence addressing drug problems (adjusted odds ratio [AOR] = 2.05, 95% confidence interval [95% CI] = 1.08-3.88) and concern about lack of access to addiction experts (AOR = 0.56, 95% CI = 0.32-0.97) were significantly associated with having a buprenorphine waiver.
Among HIV physicians attending educational conferences, confidence addressing drug problems was positively associated with having a buprenorphine waiver, and concern about lack of access to addiction experts was negatively associated with it. HIV physicians are uniquely positioned to provide opioid addiction treatment in the HIV primary care setting. Understanding and remediating barriers HIV physicians face may lead to new opportunities to improve outcomes for opioid-dependent HIV-infected patients.</abstract><cop>Heidelberg</cop><pub>Springer</pub><pmid>17619934</pmid><doi>10.1007/s11606-007-0264-7</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0884-8734 |
| ispartof | Journal of general internal medicine : JGIM, 2007-09, Vol.22 (9), p.1325-1329 |
| issn | 0884-8734 1525-1497 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Addictive behaviors Adult Adult and adolescent clinical studies Biological and medical sciences Buprenorphine - therapeutic use Cross-Sectional Studies Drug addiction Drug and Narcotic Control Drug Prescriptions Female General aspects HIV HIV Infections - complications HIV Infections - drug therapy Human immunodeficiency virus Humans Internal medicine Male Medical sciences Middle Aged Miscellaneous Narcotics Opioid-Related Disorders - complications Opioid-Related Disorders - drug therapy Physicians Populations at Risk Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Public health. Hygiene Public health. Hygiene-occupational medicine Substance abuse treatment Waivers |
| title | Barriers to obtaining waivers to prescribe buprenorphine for opioid addiction treatment among HIV physicians |
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