[ad_1]
TUESDAY, June 4, 2019 (HealthDay News) – When opioid addicts make the tough decision of quitting, the last thing they face is the barriers to treatment.
Still, a new "secret purchase" study suggests that most addicts looking for a buprenorphine prescription – which helps people to stop using opioids – would have a hard time getting an appointment. you with a qualified doctor to administer the drug.
When researchers called doctors' offices as drug addicts seeking a prescription for buprenorphine to stop using heroin, 46% of those who reported having Medicaid were denied an appointment, while 38% of those who said that they would pay in cash. have been repressed.
"When people are looking for treatment, you want to make things as simple as possible, but our study has shown that you have to be persistent enough, which can be difficult and could cause them to quit," said Dr. Michael Barnett, lead author of l & # 39; study. He is badistant professor in health policy and management at Harvard T.H. Chan School of Public Health in Boston.
Barnett has stated that buprenorphine is "a long-acting drug that stimulates the same brain receptors as opioids, helps calm cravings without euphoria or high concentration of opioids, and allows people to get their lives back. "
The problem with prescribing, however, is that people need mild to moderate withdrawal before they can receive the drug. Paradoxically, if you take opioids and take buprenorphine, you end up in immediate and difficult withdrawal. So, this must be carefully administered by someone who has had the right training, explained Barnett.
Providers must obtain a federal exemption to prescribe buprenorphine. Doctors must undergo eight-hour training, and nurse practitioners and medical badistants must complete a 24-hour training. In the United States, less than 6% of physicians benefit from these exemptions. And even those who do not always prescribe the drug actively.
The US Department of Addiction and Mental Health Services maintains a public list of physicians who have agreed to be included on this list when they have obtained their dispensation for the prescription of buprenorphine.
For the study, two researchers called the doctors on this list. They posed as heroin addicts looking for an appointment for a buprenorphine prescription. They settled either as a patient with Medicaid, or as a person who would pay in cash. Each doctor's office was called twice, several weeks apart.
The researchers had planned to call nearly 1,100 providers in six states. However, 530 of the providers were removed from the list because they had invalid contact information (such as a phone number that was not working) or that they no longer prescribed buprenorphine.
Some of the remaining doctors could not be reached. For example, their phone may have gone to voicemail instead of a live person. The researchers performed just over 430 calls as a Medicaid patient and nearly 420 as cash payers.
Only between half and two-thirds of the doctors who made appointments planned to make an order at the first visit.
The study highlighted that when researchers found a doctor willing to make an appointment, the waiting time was often less than two weeks.
"We have a prescribing workforce that is open to business and ready to help, but it can be difficult for patients to find these providers in these directories," Barnett said.
In terms of why people, particularly the Medicaid group, have trouble getting an appointment, Barnett explained that the reasons were so many. The first is that Medicaid can create barriers to the prescription of buprenorphine, for example by requiring prior authorization before prescribing the drug. In addition, some doctors did not want to accept cash payments.
And, he said, these patients may still be stigmatized. "These are just people, it's like treating any other chronic condition, and buprenorphine can literally transform people's lives," Barnett explained.
The results were published on June 3 in the Annals of Internal Medicine.
Dr. Pooja Lagisetty, badistant professor at the University of Michigan and front-line physician herself, co-authored an editorial that accompanied the study. "There was a big difference between those who agreed to take Medicaid and the patients who self-pay, which makes you wonder if the insurance may not pay enough," he said. she declared.
"Drug addiction is a disease, and people get better with this drug when they take it long-term.We must ensure that providers are well reimbursed for the care they provide," he said. said Mr. Lagisetty.
Dr. Paul Earley, president of the American Society of Addiction Medicine, said: "What is most disconcerting is that some of the states that experience the worst opioid overdose are those where people have more trouble getting an appointment. "
Earley said that in this era of data, it should not be too difficult to ask a doctor to make sure to annually update their information on the list, so that people who are looking for to get help are not frustrated by outgoing call numbers. up to date and do not work.
He also said that doctors seeking federal exemptions to prescribe should set up a system of care for these patients. Earley said they needed urine tests to make sure they were taking the drugs as they should and that they needed to be called more often with them. appointment reminders.
"All of these things require some work to put in place," he said. But this can be done successfully, Earley noted, pointing out the doctors who were able to see the patients quickly in this study.
More information
Learn more about buprenorphine from the US Addiction and Mental Health Administration.
SOURCES: Michael Barnett, MD, MS, Assistant Professor, Health Policy and Management, Harvard TH Chan School of Public Health and Adjunct Professor at Harvard Medical School and Primary Doctor at Brigham Hospital & Women & # 39 Boston; Pooja Lagisetty, M.D., M.Sc., Assistant Professor, Division of General Internal Medicine, University of Michigan, Ann Arbor; Paul Earley, MD, president of the American Society of Addiction Medicine; June 3, 2019, Annals of Internal Medicine
[ad_2]Source link
