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Expanding Access to Medications for Opioid Use Disorder Treatment Through Incentivized Continuing Education
Elizabeth Salisbury-Afshar1, Dennis Smithenry, Randy A Boley
1Ms. Salisbury-Afshar: Associate Professor, Department of Community Health and Family Medicine, University of Wisconsin, Madison, WI. Ms. Smithenry: Education Consultant, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL. Mr. Boley: Manager, Research Operations, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL. Ms. Hill: Practice Administrator, Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center. Mr. Karnik: The Cynthia Oudejans Harris, MD, Professor of Psychiatry, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL.
Introduction:
Buprenorphine treatment for opioid use disorder (OUD) has positive outcomes including reducing opioid-related morbidity and mortality. In March 2018, 58 of 102 counties in Illinois lacked access to medication for OUD.
Methods:
Rush University created a fellowship training program with financial incentives to help expand buprenorphine treatment in Illinois. Fellows first completed an online waiver course, then attended an in-person intensive training weekend, and finally participated in a 9-month webinar series. Demographic and prescribing data were collected from fellows, as well as a comparison group of providers outside the fellowship who only completed a waiver training.
Results:
At the fellowship's end, 31 of 37 fellows (84%) reported they were actively prescribing buprenorphine. Of the 23 fellows who were not prescribing at the fellowship's beginning, 17 (74%) initiated prescribing by the end. Among the 16 nonfellowship subjects who only completed a waiver training, just two (13%) reported they were prescribing buprenorphine at the study period's end.
Discussion:
Our study indicates that providers need more training beyond the waiver to initiate buprenorphine prescribing. When resources are available to address a health crisis such as OUD, this model offers an innovative mechanism for delivering continuing medical education that produces outcomes quickly.
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