PMU51 PROVIDER ATTITUDE'S, INTENTION, AND BEHAVIOR TO PRESCRIBE BUPRENORPHINE FOR THE TREATMENT OF OPIOID USE DISORDER: A SYSTEMATIC REVIEW

Substantial reduction in mortality for Opioid Use Disorder (OUD) treatment with buprenorphine has been established. Providers waivered under the Drug Addiction Treatment Act of 2000 (DATA 2000) have the ability to prescribe buprenorphine in outpatient settings. Despite a national effort to increase waivered providers, the utilization of buprenorphine has been low. This systematic literature review was conducted to describe the influence of provider attitudes, intention and behavior on the low uptake of buprenorphine. We searched the PubMed, Medline, and PsycINFO databases for studies published up to February 24, 2019. The eligibility criteria used for the searches were: (1) studies which discussed treatment of patients with OUD (2) includes providers attitude/intention and/or behavior (3) describes treatment with buprenorphine (4) setting is outpatient/office based and (5) should be US only. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Of the 354 non-duplicate citations screened, 36 articles comprising of 26 cross-sectional studies and 10 qualitative studies met the inclusion criteria for the systematic review. Overall, a high percentage of the studies (39%) have highlighted negative or neutral attitudes and intentions of providers towards treating opioid dependent patients. Some of the main barriers identified in most of the studies were insurance and prior authorization, stigma towards patients with addiction, time constraints, buprenorphine availability and lack of psycho-social services. Generalizability of the findings is often difficult as most studies are limited to specific states, organizations or specialty of providers. The findings suggest that more efforts are required to study the influence of provider attitudes, intention and behavior at the national level and in varied settings and practice types. Future research should focus on developing provider training resources during residency and after the DATA waiver is obtained.