Fewer than 3% of US ID physicians have waivers to prescribe buprenorphine
Click Here to Manage Email Alerts
Few infectious disease physicians are waivered to prescribe buprenorphine, despite being “well-positioned” to treat opioid use disorder, according to a recent study.
“We as ID physicians care for many patients with substance use disorders, either because they present to us with infectious complications of their substance use or because of co-morbid HIV and substance use disorders,” Ayako Wendy Fujita, MD, an infectious diseases fellow at the Emory University School of Medicine, told Healio. “I noticed during my fellowship training that many ID physicians are not comfortable treating underlying opioid use disorder (OUD), even though effective, evidence-based treatment exists with medications for OUD, such as buprenorphine. Out of curiosity, I did a literature search to see if there were any data on the proportion of ID physicians who had a waiver to prescribe buprenorphine and couldn’t find any national data on this.”
Fujita said she came across a study that looked at prevalence and geographic distribution of OB-GYNs who could prescribe buprenorphine, inspiring her to do a similar study among ID physicians.
Fujita and colleagues performed a cross-sectional study that merged data from several publicly available datasets gathered between Nov. 1, 2021, and Jan. 15, 2022, to determine the proportion of ID physicians with buprenorphine waivers in the U.S. The researchers identified individual and county level characteristics associated with buprenorphine waiver possession and followed up with a geospatial analysis to determine geographic distribution of waivered ID physicians.
Overall, the team identified 6,372 ID physicians in the U.S., among whom 170 (2.7%) possessed waivers.
The multivariable analysis revealed that ID physicians had lower odds of having a waiver for every 10-year increase since graduating medical school (OR = 0.79; 95% CI, 0.68-0.91), as well as if they were practicing in counties with a higher proportion of uninsured residents (OR = 0.75; 95% CI, 0.62-0.9).
Geographically, 97.3% of ID physicians in the study practiced in metropolitan counties. Among the counties with at least one ID physician (n=729), only 11.2% had an ID physician with a waiver.
“ID physicians are well-positioned to treat opioid use disorder when patients present to care with infectious complications, but our study found that nationally, very few ID physicians are waivered to prescribe buprenorphine to treat underlying OUD,” Fujita said. “Eliminating the buprenorphine waiver requirement would reduce barriers to prescribing; however until, then, we should increase the number of ID physicians who are waivered to prescribe buprenorphine.”
Collapse
Read more about
Click Here to Manage Email Alerts