title: Efficacy of continuing medical education to reduce the risk of buprenorphine diversion.
abstract: As office-based opioid dependence treatment (OBOT) has grown in the United States, postmarketing surveillance data reveal increased reports of buprenorphine misuse and diversion. It is important that doctors understand buprenorphine clinical pharmacology and engage in practices to decrease risk of misuse, diversion, and other adverse events. This study evaluated the efficacy of continuing medical education (CME) in two U.S. regions with surveillance signals of buprenorphine misuse/diversion. Four surveys (before, on-site, and 1 and 3 months post CME) evaluated physician characteristics, practice behaviors, and buprenorphine pharmacology and legislative knowledge. The results show that physicians had limited addictions training. Knowledge and practice behaviors significantly improved after the CME, which should enhance the quality of OBOT and may decrease risk of buprenorphine misuse and diversion from their practices. Mandatory CME targeting OBOT-certified physicians could have a positive impact on patient and public health outcomes.
authors.affiliation: Department of Psychiatry, University of Kentucky, Lexington, KY 40509, USA. michelle.lofwall@uky.edu
authors.forename: Michelle R
authors.initials: MR
authors.lastname: Lofwall
authors.forename: Martha J
authors.initials: MJ
authors.lastname: Wunsch
authors.forename: Paul A
authors.initials: PA
authors.lastname: Nuzzo
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Walsh
mesh_terms: D016739:Behavior, Addictive / Q000517:prevention & control / Q000523:psychology; D002047:Buprenorphine / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004502:Education, Medical, Continuing; D006801:Humans; D008137:Longitudinal Studies; D009292:Narcotic Antagonists / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D058850:Opiate Substitution Treatment / Q000523:psychology; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000517:prevention & control*; D010818:Practice Patterns, Physicians'
chemical_list: D009292:Narcotic Antagonists; D002047:Buprenorphine