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Integrating buprenorphine treatment into office-based practice: a qualitative study.

Declan T Barry¹, Kevin S Irwin, Emlyn S Jones

¹Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519-1187, USA. declan.barry@yale.edu

Journal of General Internal Medicine

|December 18, 2008

Summary

Physicians face barriers like time and expertise in offering office-based buprenorphine maintenance treatment (BMT). Addressing these challenges is key to expanding this effective opioid use disorder treatment.

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Area of Science:

Addiction Medicine
Medical Practice Management
Qualitative Research

Background:

Office-based buprenorphine maintenance treatment (BMT) is effective for opioid use disorder.
Physicians' attitudes towards BMT implementation remain understudied.

Purpose of the Study:

Identify facilitators and barriers to BMT implementation by office-based physicians.
Understand physician perspectives on integrating BMT into practice.

Main Methods:

Qualitative study utilizing semi-structured interviews with 23 physicians.
Thematic coding of interview transcripts using the constant comparative method.

Main Results:

Physicians cited patient confidentiality, cost, and motivation as patient barriers.
Physician barriers included competing activities, lack of interest, and expertise.
Logistical issues like remuneration and time were significant barriers to BMT adoption.

Conclusions:

Physician perceptions significantly influence BMT integration into primary care.
Addressing identified barriers is crucial for expanding office-based BMT.
Facilitating BMT adoption requires understanding and mitigating physician-level challenges.