Provider satisfaction with office-based treatment of opioid dependence: a systematic review.
OBJECTIVE
New federal regulations allow for office-based treatment of opioid dependent patients with opioid agonist medication (e.g., buprenorphine). We sought to evaluate the literature on office-based physicians' acceptance of this practice.


METHODS
We searched the MEDLINE database for original research examining office-based providers' acceptance or satisfaction with office-based treatment. Articles included in the analysis met the following criteria: (1) discussed the treatment of patients with substance abuse disorders, (2) focused on the treatment of opioid dependent patients, (3) discussed treatment with opioid agonist therapy, (4) discussed treatment by office-based physicians, (5) presented original research, and (6) provided data examining physician acceptance or satisfaction.


RESULTS
Eight studies met the criteria. Their heterogeneity precluded aggregate analysis. Four of 8 studies revealed that providers had a positive perception concerning the efficacy of opioid agonist treatment, 4/8 indicated that providers believed that opioid dependent patients were more complex than others in their practices, and 3/8 studies indicated the need for additional support services.


CONCLUSIONS
There are few studies of provider satisfaction with office-based treatment of opioid dependence. This literature reveals overall provider acceptance of this practice but highlights the need for support services. Further research, designed to identify the barriers to provider satisfaction with office-based opioid agonist therapy, is needed to ensure that these barriers do not limit expansion of this practice.
Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520-8025, USA.
William C
WC
Becker
David A
DA
Fiellin
D000553:Ambulatory Care; D001291:Attitude of Health Personnel; D002047:Buprenorphine / Q000627:therapeutic use*; D003299:Cooperative Behavior; D006801:Humans; D008691:Methadone / Q000627:therapeutic use*; D009294:Narcotics / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D010348:Patient Care Team; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000523:psychology*
D009294:Narcotics; D002047:Buprenorphine; D008691:Methadone