ED-Initiated Buprenorphine for OUD Often Not Sustained

THURSDAY, March 31, 2022 (HealthDay News) — The majority of patients filling buprenorphine prescriptions written by emergency physicians for the treatment of opioid use disorder do not subsequently fill buprenorphine prescriptions written by other clinicians, according to a study published online March 16 in the Annals of Emergency Medicine.

Bradley D. Stein, M.D., Ph.D., from RAND Corporation in Pittsburgh, and colleagues used retail pharmacy claims to identify buprenorphine prescriptions filled between Feb. 1, 2019, and Nov. 30, 2020, that were written by emergency physicians. The rate of subsequently filled buprenorphine prescriptions from clinicians other than emergency physicians was assessed.

The researchers identified 22,846 prescriptions written by emergency physicians and filled by buprenorphine-naïve patients. Medicaid most commonly paid for the prescriptions, and they were most often filled in metropolitan counties. More than one-quarter of patients (28.5 percent) subsequently filled buprenorphine prescriptions written by other clinicians. Most subsequent prescriptions were written by adult primary care physicians and advanced practice providers (e.g., physician assistants and nurse practitioners). After the COVID-19 public health emergency declaration, the rates of subsequent prescriptions were 3.5 percent lower.

“It’s positive that more people are being given medication for their opioid use disorder when they seek help in an emergency department. But there is substantial room for improvement to create a system of care that seamlessly transitions patients from the emergency setting to community treatment providers who can continue treatment,” Stein said in a statement. “The remaining challenge is to implement these models across diverse systems and to incentivize policymakers, insurers, and health systems to provide the necessary resources and infrastructure for such programs to be successful.”

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