According to a new study by RAND Corporation, most prescriptions for the drug buprenorphine, which is used to treat opioid use disorder, are written by a small number of healthcare providers.
Published in the June 1 edition of the Journal of the American Medical Association, the study found that half of all patients-months of buprenorphine only 4.9% of physicians and other providers who prescribed the drug during the period prescribed treatment during 2016 and 2017.
“These findings have important implications for efforts to increase access to buprenorphine,” said Dr. Bradley D. Stein, lead author of the study and senior medical researcher at RAND, a nonprofit research organization. “Our study suggests that efforts to encourage more current prescribers to become high – volume prescribers and to encourage existing high – volume prescribers to safely and effectively treat even more patients may be a powerful way to increase buprenorphine treatment capacity “.
Buprenorphine is a medicine that helps people opioid addiction to control their disease and refrain from illicit use of opioids. Approved for use in 2002, buprenorphine may be prescribed by office physicians and other health care providers, such as practicing nurses, historically once they have completed an approved course.
Traditional opioid treatment programs usually require patients to take methadone in situ at a clinic under the direct supervision of a health care provider. These programs are usually found in urban areas, leaving many people in rural areas with little access to treatment.
With approximately 2 million people affected by opioid use disorder nationwide, previous research has shown that increased use of buprenorphine has made drug treatment more accessible to more people in need of help.
In the new study, RAND researchers used IQVIA prescription data, which captures approximately 90% of all prescriptions filled at U.S. retail pharmacies, to identify doctors who prescribed buprenorphine formulations used to treat opioid use disorder at least once between January 2017 and December 2018 and calculated the total months of patient care provided by each clinician.
The total number of patient-months of buprenorphine treatment was driven by a small percentage of high-volume prescribers. Half of all patient-months of buprenorphine treatment during 2017-2018 were prescribed by the most active 4.9% (a total of 2,450 prescribers).
These high-volume prescribers treated an average of 124 patients per month, with primary care physicians (63.6%), psychiatrists (14.3%), pain specialists (8.3%), and addiction specialists ( 4.4%), which accounted for approximately 90% of volume prescribers.
The monthly number of patient cases for most of these providers was well below the current patient limit of 275 patients who received buprenorphine at one time.
“Since a relatively low number of providers account for most of the buprenorphine prescription, providing specific support to those who are willing to deal more safely with more patients may be a more promising strategy to increase drug treatment among people. with difficulties opioids addiction should focus primarily on increasing the number of new prescribers, ”Stein said.
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