Multilevel Community and Primary Care Team Intervention Increased Buprenorphine Uptake in Rural Communities

Buprenorphine is a highly effective yet underutilized medication for opioid use disorder (OUD). Well-documented barriers extend beyond clinicians’ need to obtain a waiver to prescribe buprenorphine and include practice environment and supports. This implementation study targeted both the community—to improve understanding of OUD and its treatments—as well as training for practice teams on buprenorphine delivery in primary care. Forty-two rural primary care practices in Colorado enrolled in the practice training.

• On a 23-item implementation checklist for provision of buprenorphine in primary care, the mean number of items present increased from 4.7 to 13 per practice after the intervention.
• After the intervention, 23% of practices reported at least one buprenorphine induction compared with 9% of practices prior to the intervention.
• Using Prescription Drug Monitoring Program data, the number of individuals receiving buprenorphine increased 87% in counties with participating practices, compared with a 65% increase in other counties in the state.

Comments: These data show promise for an intervention targeting community members and primary care clinicians; practices can improve clinicians’ readiness to prescribe and patients’ receipt of buprenorphine. Improving the reach of buprenorphine should include efforts beyond increasing the number of clinicians eligible to prescribe it.

Marc R. Larochelle, MD, MPH

Reference: Zittleman L, Curcija K, Nease DE Jr, et al. Increasing capacity for treatment of opioid use disorder in rural primary care practices. Ann Fam Med. 2022;20:18–23.