Integrating buprenorphine treatment into family medicine resident clinic
Tiemstra JD, Walsh LH. Integrating buprenorphine treatment into family medicine resident clinic. Fam Med. 2020;52(9):653-655. doi: 10.22454/FamMed.2020.783547.
BACKGROUND AND OBJECTIVES: Medication-assisted treatment (MAT) for opioid use disorder with buprenorphine in primary care is effective and patient-accessible yet remains underutilized, including among residency training programs. One concern in residency programs is that MAT patients must be seen at least monthly and will overwhelm residents' clinic schedules and dilute their clinical experience. Our family medicine residency initiated an MAT program integrated into residents' continuity clinic schedules. After 2 years we assessed the chronic medical comorbidities we were managing in our MAT population.
METHODS: We performed a retrospective review of all active patients receiving MAT. We collected basic demographic data and whether we were the patient's primary care provider (PCP) or were only providing MAT. For the patients for whom we were the PCP we recorded the chronic comorbidities that required medical management.
RESULTS: One hundred fifty-seven active patients were 52% male and 48% female. The mean age was 38 years (SD=10) with a range of 22 to 77 years, with nine patients over age 60 years (6%). One hundred three patients used us as their PCP (66%). For these patients the mean number of chronic comorbidities was 2.3; only 10 patients reported no comorbidities. Psychiatric comorbidities were the most common with 69% of patients with a mood disorder, although nonpsychiatric comorbidities still averaged 1.5 per patient.
CONCLUSIONS: MAT integrated into family medicine resident continuity clinics provides a broad and substantial primary care clinical experience for residents.