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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 7 of 7 Research Studies DisplayedMeiselbach MK, Drake C, Saloner B
Medicaid managed care: access to primary care providers who prescribe buprenorphine.
This study examined variation in access to in-network buprenorphine-prescribing primary care providers that can treat opioid use disorder among Medicaid managed care enrollees. Approximately 32.2% of Medicaid enrollees had fewer than one in-network network buprenorphine-prescribing primary care providers per 100,000 county residents. There was on average a greater number of in-network buprenorphine-prescribing primary care providers in states with higher compared with lower overdose death rates, but most enrollees lived in areas with a shortage of these providers. The authors found that a 25 percent higher network participation rate by prescribers compared with nonprescribers could improve the probability that enrollees see a prescriber by approximately 25 percent.
AHRQ-funded; HS000029.
Citation: Meiselbach MK, Drake C, Saloner B .
Medicaid managed care: access to primary care providers who prescribe buprenorphine.
Health Aff 2022 Jun;41(6):901-10. doi: 10.1377/hlthaff.2021.01719..
Keywords: Medicaid, Primary Care, Access to Care, Medication, Care Management, Opioids, Substance Abuse, Behavioral Health
Gertner AK, Rotter JS, Holly ME
The role of primary care in the initiation of opioid use disorder treatment in statewide public and private insurance.
This observational study’s goal was to determine if individuals newly diagnosed with opioid use disorder (OUD) who saw a primary care provider (PCP) before or on the date of diagnosis had higher rates of medication treatment for OUD (MOUD). Claims data from Medicaid and a large private insurer in North Carolina from January 2014 to July 2017 was used. During the period from 2014 to 2017, the prevalence of diagnosed OUD increased by 47% among Medicaid enrollees and by 76% among the privately insured. Over the same time period the number of people with an OUD who received MOUD fell among both groups, while PCP involvement in treatment increased. The percent of Medicaid enrollees receiving buprenorphine from a PCP increased from 32% in 2014 to 39% in 2017. In the 12 months before being newly diagnosed, approximately 82% with Medicaid or private insurance had a PCP visit. There was no difference in receiving an MOUD with those who had not seen a PCP. However, there was a higher probability of receiving MOUD with a PCP, than seeing an emergency provider, but lower than seeing a behavioral health specialist or other provider type.
AHRQ-funded; HS025065.
Citation: Gertner AK, Rotter JS, Holly ME .
The role of primary care in the initiation of opioid use disorder treatment in statewide public and private insurance.
J Addict Med 2022 Mar-Apr;16(2):183-91. doi: 10.1097/adm.0000000000000860..
Keywords: Primary Care, Opioids, Substance Abuse, Behavioral Health, Health Insurance
Holtrop JS, Mullen R, Curcija K
The balance between serving the community and the reality of treating opioid use disorder in rural primary care practices.
The purpose of this qualitative study was to investigate clinician and staff perceptions related to medication assisted treatment (MAT) for opioid use disorder, particularly buprenorphine treatment, in rural primary care practices. Staff members from rural 42 practices were interviewed. Although there was almost no provision of MAT, policies and procedures to reduce opioid prescribing were usually in place and many practices expressed interest in learning more to help their patients and local communities.
AHRQ-funded; HS025056.
Citation: Holtrop JS, Mullen R, Curcija K .
The balance between serving the community and the reality of treating opioid use disorder in rural primary care practices.
J Health Care Poor Underserved 2022; 33(1):253-67. doi: 10.1353/hpu.2022.0019..
Keywords: Opioids, Substance Abuse, Behavioral Health, Primary Care, Rural Health, Medication
Zittleman L, Curcija K, Nease DE
Increasing capacity for treatment of opioid use disorder in rural primary care practices.
Evidence supports treatment for opioid use disorder (OUD) with buprenorphine in primary care practices (PCPs). Barriers that slow implementation of this treatment include inadequately trained staff. This study aimed to increase the number of rural PCPs providing OUD treatment with buprenorphine. This evaluation described the impact of a practice team training on the implementation and delivery of OUD treatment with buprenorphine in PCPs of rural Colorado.
AHRQ-funded; HS025065.
Citation: Zittleman L, Curcija K, Nease DE .
Increasing capacity for treatment of opioid use disorder in rural primary care practices.
Ann Fam Med 2022 Jan-Feb;20(1):18-23. doi: 10.1370/afm.2757..
Keywords: Opioids, Rural Health, Primary Care, Substance Abuse, Behavioral Health, Training, Implementation, Medication
White AEC, Hood-Medland EA, Kravitz RL
Visit linearity in primary care visits for patients with chronic pain on long-term opioid therapy.
Physicians and patients report frustration after primary care visits for chronic pain. The need to shift between multiple clinical topics to address competing demands during visits may contribute to this frustration. This study created a novel measure, "visit linearity," to assess visit organization and examined whether visits that required less shifting back and forth between topics were associated with better patient and physician visit experiences.
AHRQ-funded; HS022236.
Citation: White AEC, Hood-Medland EA, Kravitz RL .
Visit linearity in primary care visits for patients with chronic pain on long-term opioid therapy.
J Gen Intern Med 2022 Jan;37(1):78-86. doi: 10.1007/s11606-021-06917-z..
Keywords: Opioids, Pain, Chronic Conditions, Primary Care, Medication
Kennedy-Hendricks A, Busch SH, McGinty EE
Primary care physicians' perspectives on the prescription opioid epidemic.
The authors aimed to determine primary care physicians' perceptions of the seriousness of the prescription opioid epidemic, its causes, groups responsible for addressing it, attitudes toward individuals with prescription opioid use disorder, beliefs about the effectiveness of addiction treatments, and support for various policies. They found that respondents largely attributed the causes to individual-oriented factors and certain physician-oriented factors, and that respondents believed that individuals with prescription opioid use disorder and physicians were primarily responsible for addressing the problem. The researchers also found that negative attitudes toward people with prescription opioid use disorder were prevalent, but a majority believed that treatment could be effective.
AHRQ-funded; HS000029.
Citation: Kennedy-Hendricks A, Busch SH, McGinty EE .
Primary care physicians' perspectives on the prescription opioid epidemic.
Drug Alcohol Depend 2016 Aug 1;165:61-70. doi: 10.1016/j.drugalcdep.2016.05.010.
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Keywords: Behavioral Health, Medication, Opioids, Primary Care, Substance Abuse
Penti B, Liebschutz JM, Kopcza B
Novel peer review method for improving controlled substance prescribing in primary care.
The authors sought to determine if peer feedback through a chart review tool (CRT) can impact opioid prescribing for patients with chronic noncancer pain in an outpatient family medicine clinic at an urban, safety-net teaching hospital. They reviewed 99 patient charts from 14 physicians over 1 year. They found that the mean dose of opioids decreased 2.6 mg morphine equivalent dose (MED)/day from time of chart review until the end of the project, compared to a 6.9 mg MED/day increase that occurred from 12 months prior to chart review to the time of chart review, and 14 patients were taken off of opioids after the chart review.
AHRQ-funded; HS022242.
Citation: Penti B, Liebschutz JM, Kopcza B .
Novel peer review method for improving controlled substance prescribing in primary care.
J Opioid Manag 2016 Jul-Aug;12(4):269-79. doi: 10.5055/jom.2016.0342.
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Keywords: Adverse Drug Events (ADE), Medication, Opioids, Primary Care, Practice Patterns