Abstract：
BACKGROUND:In France, most patients with opioid use disorder (OUD) have been treated by buprenorphine, prescribed by general practitioners (GP) in private practice since 1996. This has contributed to building a 'French model' facilitating access to treatment based on the involvement of GPs in buprenorphine prescription. OBJECTIVES:Our study aimed to assess whether the involvement of primary care in OUD management has changed lately. MATERIALS AND METHODS:Using data from the French National Health Insurance database, we conducted a yearly repeated cross-sectional study (2009-2015) and described proportion of opioid maintenance treatment (OMT)-prescribing GPs and OMT-dispensing community pharmacies (CP); and number of patients by GP or CP. RESULTS:Whereas the number of buprenorphine-prescribing GPs in private practice remained quite stable (decrease of 3%), a substantial decrease in buprenorphine initial prescribers among private GPs was observed. In 2009, 10.3% of private GPs (6,297 from 61,301 French private GPs) prescribed buprenorphine for the initiation of a treatment, whereas they were 5.7% (n = 3,539 from 62,071 private GPs) in 2015 (43.8% decrease). GPs issuing initial prescriptions of buprenorphine tended to care for a higher number of patients treated by buprenorphine (14.6 ± 27.1 patients in 2009 to 16.0 ± 35.4 patients in 2015). The number of CPs dispensing buprenorphine remained quite stable (decrease of 2%), while there was a 7.5% decrease in the total number of French CPs across the study period. CONCLUSIONS:Our results suggest that primary care providers seem less engaged in buprenorphine initiation in OUD patients, while CPs have not modified their involvement towards these patients.
journal_name
Eur Addict Resjournal_title
European addiction researchauthors
Dupouy J,Maumus-Robert S,Mansiaux Y,Pariente A,Lapeyre-Mestre Mdoi
10.1159/000506630subject
Has Abstractpub_date
2020-01-01 00:00:00pages
346-354issue
6eissn
1022-6877issn
1421-9891pii
000506630journal_volume
26pub_type
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