Table. Demographic and Practice Characteristics of Clinicians Responding to the Survey.
| Variable | No. (%)a | P value | ||
|---|---|---|---|---|
| DATA waiver | Practice guidelines | |||
| Prior | Concurrent | |||
| Total sample | 1365 (49.9) | 550 (20.1) | 821 (30.0) | NA |
| Gender identity | ||||
| Female | 831 (61.9) | 343 (63.4) | 396 (49.2) | <.001 |
| Male | 512 (38.1) | 198 (36.6) | 409 (50.8) | |
| Age, y | ||||
| ≤34 | 272 (20.2) | 114 (21.0) | 131 (16.1) | .23 |
| 35-44 | 418 (31.0) | 168 (31.0) | 249 (30.6) | |
| 45-54 | 318 (23.6) | 137 (25.3) | 217 (26.7) | |
| 55-64 | 228 (16.9) | 88 (16.2) | 145 (17.8) | |
| ≥65 | 113 (8.4) | 35 (6.5) | 71 (8.7) | |
| Race and ethnicity | ||||
| Hispanic | 91 (7.0) | 35 (6.6) | 44 (5.6) | <.001 |
| Non-Hispanic | ||||
| American Indian or Alaska Native | 6 (0.5) | 3 (0.6) | 2 (0.3) | |
| Asian or Pacific Islander | 130 (9.9) | 53 (9.9) | 98 (12.5) | |
| Black | 151 (11.5) | 86 (16.1) | 35 (4.5) | |
| White | 896 (68.5) | 342 (64.0) | 584 (74.3) | |
| Multiracial | 34 (2.6) | 15 (2.8) | 23 (2.9) | |
| Census region | ||||
| Northeast | 263 (19.4) | 105 (19.2) | 151 (18.4) | <.001 |
| Midwest | 332 (24.5) | 140 (25.6) | 149 (18.2) | |
| South | 333 (24.5) | 149 (27.2) | 192 (23.4) | |
| West | 429 (31.6) | 153 (28.0) | 327 (39.9) | |
| Primary practice location | ||||
| Urban | 606 (44.9) | 242 (44.6) | 416 (51.3) | <.001 |
| Suburban | 404 (29.9) | 151 (27.8) | 271 (33.4) | |
| Rural | 340 (25.2) | 150 (27.6) | 124 (15.3) | |
| Clinician type | ||||
| Physician (MD/DO) | 768 (56.4) | 264 (48.1) | 628 (76.8) | <.001 |
| NP or other nurse-eligible practitioner | 499 (36.6) | 246 (44.8) | 143 (17.5) | |
| PA | 95 (7.0) | 39 (7.1) | 47 (5.7) | |
| Primary practice specialty | ||||
| Primary care, internal medicine, or family medicine | 697 (51.3) | 295 (53.8) | 321 (39.2) | <.001 |
| Pediatrics | 14 (1.0) | 4 (0.7) | 9 (1.1) | |
| Obstetrics and gynecology | 48 (3.5) | 10 (1.8) | 15 (1.8) | |
| Emergency medicine | 228 (16.8) | 57 (10.4) | 329 (40.1) | |
| Psychiatry or addiction medicine | 263 (19.4) | 140 (25.6) | 100 (12.2) | |
| Pain medicine, anesthesiology, physical medicine, or rehabilitation | 34 (2.5) | 18 (3.3) | 13 (1.6) | |
| Palliative care and hospice care | 19 (1.4) | 7 (1.3) | 10 (1.2) | |
| Other | 56 (4.1) | 17 (3.1) | 23 (2.8) | |
| Addiction medicine credentials | ||||
| No | 1343 (98.4) | 539 (98.0) | 808 (98.4) | .81 |
| Yes | 22 (1.6) | 11 (2.0) | 13 (1.6) | |
| Years in practice since completing residency (MD/DO) or qualifying program (PA, NP, or other nurse-eligible practitioner) | ||||
| <5 | 562 (41.4) | 266 (48.6) | 207 (25.3) | <.001 |
| 5-10 | 268 (19.7) | 96 (17.6) | 164 (20.1) | |
| 11-15 | 149 (11.0) | 53 (9.7) | 115 (14.1) | |
| 16-19 | 86 (6.3) | 32 (5.9) | 82 (10.0) | |
| ≥20 | 294 (21.6) | 100 (18.3) | 250 (30.6) | |
| Primary practice setting | ||||
| Office-based solo practice | 106 (7.8) | 46 (8.4) | 46 (5.6) | <.001 |
| Office-based group practice | 386 (28.5) | 167 (30.6) | 158 (19.3) | |
| Opioid treatment program or specialty substance use facility | 29 (2.1) | 25 (4.6) | 9 (1.1) | |
| Community clinic (FQHC, RHC, CCBHC) | 232 (17.1) | 97 (17.8) | 72 (8.8) | |
| ED or urgent care | 230 (17.0) | 68 (12.5) | 326 (39.9) | |
| Criminal justice setting (including BOP) | 32 (2.4) | 14 (2.6) | 14 (1.7) | |
| Inpatient or hospital setting (not federal government) | 160 (11.8) | 60 (11.0) | 123 (15.0) | |
| Federal government (VA, DOD, or IHS) | 76 (5.6) | 31 (5.7) | 29 (3.6) | |
| Other (specify) | 103 (7.6) | 37 (6.8) | 41 (2.0) | |
| Insurance type accepted | ||||
| Medicaid | 1128 (82.6) | 443 (80.6) | 701 (85.4) | .06 |
| Medicare | 1134 (83.1) | 453 (82.4) | 700 (85.3) | .28 |
| Workers’ compensation | 529 (38.8) | 189 (34.4) | 417 (50.8) | <.001 |
| Private, commercial, other insurance | 1167 (85.5) | 486 (88.4) | 720 (87.7) | .15 |
| Do not accept any type of insurance in my practice | 81 (5.9) | 27 (4.9) | 24 (2.9) | .006 |
| Listed on SAMHSA buprenorphine locator | ||||
| No | 345 (25.6) | 136 (25.0) | 254 (31.3) | <.001 |
| Yes | 444 (32.9) | 212 (38.9) | 151 (18.6) | |
| Do not know | 560 (41.5) | 197 (36.2) | 407 (50.1) | |
| Ever interacted with PCSS-MAT | ||||
| No | 869 (63.9) | 350 (64.1) | 615 (75.4) | <.001 |
| Yes | 288 (21.2) | 107 (19.6) | 76 (9.3) | |
| Do not know | 203 (14.9) | 89 (16.3) | 125 (15.3) | |
| Sources of education about buprenorphine for OUD treatment and/or OUD diagnosis and treatment | ||||
| Medical or professional school teaching | 460 (33.7) | 175 (31.8) | 274 (33.4) | .73 |
| Postgraduate residency training | 260 (19.1) | 91 (16.6) | 184 (22.4) | .02 |
| Fellowship training | 60 (4.4) | 20 (3.6) | 34 (4.1) | .75 |
| Scientific conferences or continuing education | 751 (55.0) | 237 (43.1) | 414 (50.4) | <.001 |
| Self-directed reading of published literature or guidelines | 845 (61.9) | 321 (58.4) | 571 (69.6) | <.001 |
| Promotional materials or detailing from drug companies (not FDA REMS–related materials) | 107 (7.8) | 39 (7.1) | 41 (5.0) | .04 |
| FDA REMS materials related to buprenorphine products for OUD (eg, REMS instruction letter to prescribers, medication guide, appropriate use checklist) | 371 (27.2) | 136 (24.7) | 171 (20.8) | .004 |
| Colleagues (not part of formal training or continuing education) | 591 (43.3) | 219 (39.8) | 466 (56.8) | <.001 |
| Other | 72 (5.3) | 29 (5.3) | 33 (4.0) | .38 |
| None of the above | 55 (4.0) | 27 (4.9) | 29 (3.5) | .45 |
| Prescribed buprenorphine since obtaining waiver | ||||
| No | 483 (35.7) | 226 (41.2) | 359 (44.3) | <.001 |
| Yes | 869 (64.3) | 322 (58.8) | 451 (55.7) | |
| Prescribed buprenorphine in past 6 mo | ||||
| No | 619 (45.9) | 243 (44.4) | 359 (44.3) | .72 |
| Yes | 729 (54.1) | 304 (55.6) | 451 (55.7) | |
| Remote buprenorphine prescribing to new patientb | ||||
| No | 625 (85.7) | 265 (87.2) | 422 (93.6) | <.001 |
| Yes | 104 (14.3) | 39 (12.8) | 29 (6.4) | |
Abbreviations: BOP, Federal Bureau of Prisons; CCBHC, certified community behavioral health clinic; DATA, Drug Addiction Treatment Act; DO, doctor of osteopathic medicine; DOD, US Department of Defense; ED, emergency department; FDA REMS, US Food and Drug Administration Risk Evaluation and Mitigation Strategy; FQHC, federally qualified health center; IHS, Indian Health Service; MD, doctor of medicine; NA, not applicable; NP, nurse practitioner; OUD, opioid use disorder; PA, physician assistant; PCSS-MAT, Providers Clinical Support System for Medication Assisted Treatment; RHC, rural health clinic; SAMHSA, Substance Abuse and Mental Health Services Administration; VA, US Department of Veterans Affairs.
a
Respondents had the ability to skip specific demographic and clinical practice characteristic questions. Thus, responses for an individual characteristic may not sum to the total number of respondents for each waiver approval type category.
b
Among clinicians who reported prescribing in the past 6 months for those obtaining a traditional DATA waiver or since obtaining a waiver under the practice guidelines.