Objectives: Since 2003, a new form of treatment for opioid dependence (OD), called buprenorphine medication-assisted treatment (B-MAT), has become increasingly available in the United States. The purpose of this study was to measure self-reported psychiatrists' practice patterns, personal and professional characteristics, and psychiatrists' barriers to treating OD patients with office-based opioid therapy.
Methods: Managed care network psychiatrists waivered to prescribe buprenorphine for treating OD were surveyed (N = 294) about specific skills and barriers to increasing the number of OD patients treated with B-MAT. Psychiatrists completed a self-administered survey about attitudes, beliefs, skills, experiences in general practice, and experience treating chronic disease, addiction, and OD.
Results: Of the 11 barriers measured on the survey, the 5 that were endorsed by the greatest number of psychiatrists as affecting their decision to use B-MAT or increase the number of B-MAT patients were as follows: urine testing requirements and logistical issues, possibility of patients selling their buprenorphine or taking more than prescribed, attracting more OD patients to their practice, concern about drug enforcement agency intrusion, and belief of greater time commitment for treating B-MAT patients.
Conclusion: Barriers were perceived to exist, and the perception of the level of these barriers varied significantly between psychiatrists whose B-MAT practices were growing and those whose practices were not. The findings suggest that to increase the use of B-MAT by waivered psychiatrists, support services and medical education programs should focus on the barriers that are rated the most influential by psychiatrists whose patient sample was decreasing or remaining flat.
From the Department of Quality, Outcomes and Research (JA, AE), and Division of Behavior Health (RC), Magellan Health Services; and Department of Translational Sciences (JT, CR), Health Analytics, Columbia, MD.
Received for publication July 31, 2009; accepted October 27, 2009.
Send correspondence and reprint requests to Joann Albright, PhD, Outcomes and Research, Magellan Health Services, 6950 Columbia Gateway Drive, Columbia, MD 21046. e-mail: firstname.lastname@example.org
Supported in part by Reckitt Benckiser Pharmaceuticals.
This study was conducted by Magellan Health Services, Inc. in collaboration with Health Analytics, LLC.