Abstract:
BACKGROUND:Despite the availability and demonstrated effectiveness of office-based buprenorphine maintenance treatment (BMT), the systematic examination of physicians' attitudes towards this new medical practice has been largely neglected. OBJECTIVE:To identify facilitators and barriers to the potential or actual implementation of BMT by office-based medical providers. DESIGN:Qualitative study using individual and group semi-structured interviews. PARTICIPANTS:Twenty-three practicing office-based physicians in New England. APPROACH:Interviews were audiotaped, transcribed, and entered into a qualitative software program. The transcripts were thematically coded using the constant comparative method by a multidisciplinary team. RESULTS:Eighty percent of the physicians were white; 55% were women. The mean number of years since graduating medical school was 14 (SD = 10). The primary areas of clinical specialization were internal medicine (50%), infectious disease (20%), and addiction medicine (15%). Physicians identified physician, patient, and logistical factors that would either facilitate or serve as a barrier to their integration of BMT into clinical practice. Physician facilitators included promoting continuity of patient care, positive perceptions of BMT, and viewing BMT as a positive alternative to methadone maintenance. Physician barriers included competing activities, lack of interest, and lack of expertise in addiction treatment. Physicians' perceptions of patient-related barriers included concerns about confidentiality and cost, and low motivation for treatment. Perceived logistical barriers included lack of remuneration for BMT, limited ancillary support for physicians, not enough time, and a perceived low prevalence of opioid dependence in physicians' practices. CONCLUSIONS:Addressing physicians' perceptions of facilitators and barriers to BMT is crucial to supporting the further expansion of BMT into primary care and office-based practices.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Barry DT,Irwin KS,Jones ES,Becker WC,Tetrault JM,Sullivan LE,Hansen H,O'Connor PG,Schottenfeld RS,Fiellin DAdoi
10.1007/s11606-008-0881-9subject
Has Abstractpub_date
2009-02-01 00:00:00pages
218-25issue
2eissn
0884-8734issn
1525-1497journal_volume
24pub_type
杂志文章abstract:OBJECTIVE:To determine the frequency with which an acute confusional state is caused by a stroke and to evaluate the usefulness of obtaining computed tomography scans in this setting. DESIGN:Retrospective analysis. SETTING:Tertiary referral center. PATIENTS:The authors reviewed 127 neurology consultations requested ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599217
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:Disparities can be caused by minorities receiving care in low-quality settings. The patient-centered medical home (PCMH) has been identified as a model of high-quality primary care that can eliminate disparities. However, Latinos are less likely to have PCMHs. OBJECTIVE:To identify Latino subgroup variation...
journal_title:Journal of general internal medicine
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更新日期:2009-11-01 00:00:00
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更新日期:2002-10-01 00:00:00
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更新日期:2009-06-01 00:00:00
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更新日期:2020-07-01 00:00:00
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更新日期:2019-12-01 00:00:00
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更新日期:2009-07-01 00:00:00
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更新日期:2010-12-01 00:00:00
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journal_title:Journal of general internal medicine
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更新日期:1996-03-01 00:00:00
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更新日期:1991-01-01 00:00:00
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更新日期:2002-11-01 00:00:00
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更新日期:2008-10-01 00:00:00
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更新日期:2007-10-01 00:00:00
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更新日期:2003-04-01 00:00:00
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更新日期:2008-05-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2016-02-01 00:00:00