HealthDay News – About half of waivered clinicians prescribe buprenorphine for opioid use disorder and most treat at levels below their patient limits, according to a research letter published online August 24 in JAMA Network Open.

Alexandra Duncan, Dr. PH, MPH, from The Pew Charitable Trusts in Washington, DC, and colleagues examined the number of patients treated with buprenorphine by waivered clinicians. The monthly clinician-level patient census was calculated for the period of April 2017 to January 2019 for patients receiving buprenorphine for opioid use disorder. The percentage of clinicians actively prescribing and the percentage of clinicians prescribing by patient limit were also calculated.

The researchers found that during the 22-month period, 50.9% of the 55,938 waivered clinicians identified wrote at least 1 buprenorphine prescription. The percentages were more than twofold higher for actively prescribing clinicians with 275 patients and actively prescribing clinicians with 100 patients compared with actively prescribing clinicians with 30 patients (98 and 84.1%, respectively, vs 38.9%). The median monthly patient census was 101.5 for the 275-patient clinicians, 23.9 for the 100-patient clinicians, and 3.4 for the 30-patient clinicians, representing 36.9, 23.9, and 11.3% of their patient limits, respectively.

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“Our findings suggest the need for ongoing efforts to address treatment barriers, including policy efforts to minimize concerns about US Drug Enforcement Administration oversight, increase clinician and care coordination reimbursement, and support waivered clinicians caring for patients,” the authors write.

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