Outcomes of a novel office-based opioid treatment program in an internal medicine resident continuity practice

• Published in: Addiction science & clinical practice 2019-12, Vol.14 (1), p.46-7, Article 46
• Main Authors: Pytell, Jarratt D, Buresh, Megan E, Graddy, Ryan
• Format: Article
• Language: English
• Subjects: Adult; Aged; Attitudes; Buprenorphine; Buprenorphine - therapeutic use; Care and treatment; Chart reviews; Clinical outcomes; College graduates; Curricula; Drug dosages; Drug use; Education; Education, medical, graduate; Employee attitude; Evidence-based medicine; Female; Health Knowledge, Attitudes, Practice; Humans; Inservice Training - organization & administration; Insurance coverage; Integrated care; Internal medicine; Internal Medicine - education; Internal Medicine - organization & administration; Internship and Residency - organization & administration; Intervention; Male; Medical education; Medical personnel training; Medical practices; Medical referrals; Medical research; Medical schools; Medicine; Middle Aged; Narcotic Antagonists - therapeutic use; Narcotics; Novels; Office based opioid treatment; Opiate Substitution Treatment - methods; Opioid abuse; Opioid-related disorder; Opioid-Related Disorders - drug therapy; Opioids; Patient outcomes; Patients; Physicians; Polls & surveys; Prescription drugs; Primary care; Professional attitudes; Resident physicians; Retrospective Studies; Social workers; Substance abuse treatment; Substance use disorder; Surveys; Toxicology; Treatment programs; Urine; Waivers
• ISSN: 1940-0640; 1940-0632; 1940-0640
• DOI: 10.1186/s13722-019-0175-z

The integration of opioid use disorder (OUD) care and competencies in graduate medical education training is needed. Previous research shows improvements in knowledge, attitudes, and practices after exposure to OUD care. Few studies report outcomes for patients with OUD in resident physician continuity practices. A novel internal office-based opioid treatment (OBOT) program was initiated in a resident continuity clinic. Surveys of resident and staff knowledge and attitudes of OBOT were administered at baseline and 4 months. A retrospective chart review of the 15-month OBOT clinic obtained patient characteristics and outcomes. Twelve patients with OUD were seen in the OBOT clinic. Seven patients (58%) were retained in care at the end of the study period for a range of 9-15 months. Eight patients demonstrated a good clinical response. Surveys of residents and staff at 4 months were unchanged from baseline showing persistent lack of comfort in caring for patients with OUD. OBOT can be successfully integrated into resident continuity practices with positive patient outcomes. Improvement in resident and staff attitudes toward OBOT were not observed and likely require direct and frequent exposure to OUD care to increase acceptance.