The problem

Approximately 2.6 million Americans have opioid use disorder (OUD), but only 10.6% have received treatment (Tong, 2018), mainly because there are not enough buprenorphine waivered providers, especially in rural areas (Andrilla, 2019). Based on the Centers for Disease Control and Prevention (2017) mortality data, opioid overdoses result in an estimated average of 115 deaths per day. There is a need to address attitudes and barriers of why primary care providers are reluctant to get buprenorphine waivers.

The literature

There are a number of reasons why primary care providers are not getting their buprenorphine license. A recent study reported that only 28.6% of family medicine residencies have a required addiction medicine curriculum. Only 31.2% had at least one graduate obtain a waiver to prescribe buprenorphine in the past year. Promoting buprenorphine treatment through training and education increases the number of buprenorphine providers (Tong, 2018).

Plan for resolution

An educational program was presented to health care providers in rural upstate New York. The goal of this presentation was to improve provider knowledge about the need for buprenorphine waivered providers in the rural primary care setting. A pretest and posttest were given to measure attitudes and barriers before and after the presentation.

Outcomes

When pre-test attitude scores were compared to post-test attitude scores using paired T-test, t =-3.756, 2-tailed test, it was found to be significant at p = 0.001. Providers that had buprenorphine training in residency or took a buprenorphine class were more likely to have their buprenorphine license, which is statistically significant. Significance was determined using descriptive statistics, crosstabs, x2 = 11.657, p = 0.001. Providers were found to have a greater intention of prescribing buprenorphine after the training provided. This is also statistically significant using descriptive statistics, crosstabs, Pearson Chi-square with a value of x2 = 10.796, 2-sided p=0.013. The data also showed that providers who were previously educated through residency or who took a buprenorphine class, were more likely to treat OUD with buprenorphine at the 6-week follow-up time of this training. This is statistically significant using descriptive statistics, crosstabs, Pearson Chi-square with a value of x2 = 8.327, 2-sided p=0.004.

Conclusions and recommendations

This presentation improved provider attitudes in treating patients with OUD with buprenorphine. Even though a small percentage of providers are willing to get their buprenorphine license, providers receiving multiple doses of buprenorphine education had an increased likelihood of treating OUD with buprenorphine. Therefore, repeating buprenorphine education is essential. Education increases discussion about the benefits of treating patients with OUD in rural communities and it is recommended that medical professionals who already have their buprenorphine licenses, facilitate this presentation to fellow providers in an effort to educate and mentor them.