Buprenorphine unobserved "home" induction: a survey of Ontario's addiction physicians.
Addiction Medicine
/ standards
Attitude of Health Personnel
Buprenorphine
/ administration & dosage
Cross-Sectional Studies
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Methadone
/ therapeutic use
Narcotics
/ administration & dosage
Ontario
Opiate Substitution Treatment
/ methods
Opioid-Related Disorders
/ drug therapy
Practice Guidelines as Topic
Practice Patterns, Physicians'
/ statistics & numerical data
Buprenorphine
Home induction
Physician survey
Unobserved
Journal
Addiction science & clinical practice
ISSN: 1940-0640
Titre abrégé: Addict Sci Clin Pract
Pays: England
ID NLM: 101316917
Informations de publication
Date de publication:
01 05 2019
01 05 2019
Historique:
received:
11
09
2018
accepted:
26
03
2019
entrez:
2
5
2019
pubmed:
2
5
2019
medline:
19
5
2020
Statut:
epublish
Résumé
Ontario patients on opioid agonist treatment (OAT) are often prescribed methadone instead of buprenorphine, despite the latter's superior safety profile. Ontario OAT providers were surveyed to better understand their attitudes towards buprenorphine and potential barriers to its use, including the induction process. We used a convenience sample from an annual provincial conference to which Ontario physicians who are involved with OAT are invited. Based on 85 survey respondents (out of 215 attendees), only 4% of Ontario addiction physicians involved in OAT routinely used unobserved "home" buprenorphine induction: 59% of physicians felt that unobserved induction was risky because it was against "the guidelines" and 66% and 61% respectively believed that unobserved "home" induction increased the risk of diversion and of precipitated withdrawal. Ontario addiction physicians largely report following the traditional method of bringing in patients for observed in-office buprenorphine induction: they expressed fear of precipitated withdrawal, diversion, and going against clinical guidelines. The hesitance in using unobserved induction may explain, in part, Ontario's reliance on methadone.
Sections du résumé
BACKGROUND
Ontario patients on opioid agonist treatment (OAT) are often prescribed methadone instead of buprenorphine, despite the latter's superior safety profile. Ontario OAT providers were surveyed to better understand their attitudes towards buprenorphine and potential barriers to its use, including the induction process.
METHODS
We used a convenience sample from an annual provincial conference to which Ontario physicians who are involved with OAT are invited.
RESULTS
Based on 85 survey respondents (out of 215 attendees), only 4% of Ontario addiction physicians involved in OAT routinely used unobserved "home" buprenorphine induction: 59% of physicians felt that unobserved induction was risky because it was against "the guidelines" and 66% and 61% respectively believed that unobserved "home" induction increased the risk of diversion and of precipitated withdrawal.
CONCLUSIONS
Ontario addiction physicians largely report following the traditional method of bringing in patients for observed in-office buprenorphine induction: they expressed fear of precipitated withdrawal, diversion, and going against clinical guidelines. The hesitance in using unobserved induction may explain, in part, Ontario's reliance on methadone.
Identifiants
pubmed: 31039821
doi: 10.1186/s13722-019-0146-4
pii: 10.1186/s13722-019-0146-4
pmc: PMC6492403
doi:
Substances chimiques
Narcotics
0
Buprenorphine
40D3SCR4GZ
Methadone
UC6VBE7V1Z
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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