Abstract
Objective
We aimed to assess physicians' perceptions of barriers to starting medication-assisted treatment (MAT) in the Emergency Department (ED), views of the utility of MAT, and abilities to link patients with opioid use disorder (OUD) to MAT programs in their respective communities.
Methods
This was a cross-sectional survey study of American emergency medicine (EM) physicians with a self-administered online survey via SurveyMonkey (Survey Monkey, San Mateo, California). The survey was emailed to the Council of Residency Directors in Emergency Medicine (CORD) listserv and HCA Healthcare affiliated EM residency programs' listservs. Attendings and residents of all post-graduate years participated. Questions assessed perceptions of barriers to starting OUD patients on MAT, knowledge of the X-waiver, and knowledge of MAT details. Statistics were performed with JMP software (SAS Institute Inc., Cary, NC) using the two-tailed Z-test for proportions.
Results
There were 98 responses, with 33% female, 55% resident physicians, and an overall 17% response rate. Residents were more eager to start OUD patients on MAT (71% vs 52%, p=0.04) than attendings but were less familiar with the X-waiver (38% vs 73%, p=0.001) or where community outpatient MAT facilities were (21% vs 43%, p=0.02).
Conclusion
Barriers in the ED were identified as a shortage of qualified prescribers, the lengthy X-waiver process, and the poor availability of outpatient MAT resources. EM residents showed more willingness to prescribe MAT but lacked a core understanding of the process. This shows an area of improvement for residency training as well as advocacy among attendings.
Document Type
Article
Publication Date
11-26-2021
Digital Object Identifier (DOI)
https://doi.org/10.7759/cureus.19923
Funding Information
This research was supported (in whole or in part) by HCA Healthcare and/or an HCA Healthcare affiliated entity.
Repository Citation
Logan, Gideon; Mirajkar, Amber; Houck, Jessica; Rivera-Alvarez, Fernando; Drone, Emily; Patel, Parth; Craen, Alexandra; Dub, Larissa; Elahi, Nubaha; Lebowitz, David; Walker, Ayanna; and Ganti, Latha, "Physician-Perceived Barriers to Treating Opioid Use Disorder in the Emergency Department" (2021). Emergency Medicine Faculty Publications. 7.
https://uknowledge.uky.edu/emergency_facpub/7
Notes/Citation Information
Published in Cureus, v. 13, issue 11, 19923.
Copyright © 2021, Logan et al.
This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.