Accessing the Oregon Frontier: The Impact of Expanding Authority for Buprenorphine to Nurse Practitioners

Institution

OHSU

Program/Major

PhD/Epidemiology

Degree

PhD

Presentation Type

Poster

Start Date

4-7-2020 2:52 PM

End Date

4-7-2020 2:57 PM

Persistent Identifier

https://archives.pdx.edu/ds/psu/33746

Keywords

MOUD, OUD, Buprenorphine, prescribing, PDMP

Abstract

Objective: Expanding access to medications for opioid use disorder (OUD) is a critical strategy to confront the opioid crisis. In 2017, the Comprehensive Addiction and Recovery Act (CARA) expanded buprenorphine prescribing privileges to nurse practitioners (NP). The object of this study was to evaluate the effect of CARA buprenorphine prescribing for OUD in Oregon.

Study Design: Using data from Oregon’s Prescription Drug Monitoring Program, we examined the effect of CARA enactment on buprenorphine prescribing using an interrupted time series design. We quantified changes in buprenorphine use between January 1, 2016 to December 31, 2018 overall, by provider type (NP vs MD/DO), and geography (rural, urban, frontier).

Results: Post CARA, the trend in buprenorphine use increased by 211 prescriptions per month (p=0.05). The percent attributed to waivered NPs increased by 0.7% per month (p

Conclusions: Buprenorphine dispensing rates in Oregon increased significantly following CARA implementation. The impact of adding NPs as authorized prescribers has enhanced access to buprenorphine prescriptions in rural and sparsely populated areas of the state where such patients were previously underserved.

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Apr 7th, 2:52 PM Apr 7th, 2:57 PM

Accessing the Oregon Frontier: The Impact of Expanding Authority for Buprenorphine to Nurse Practitioners

Objective: Expanding access to medications for opioid use disorder (OUD) is a critical strategy to confront the opioid crisis. In 2017, the Comprehensive Addiction and Recovery Act (CARA) expanded buprenorphine prescribing privileges to nurse practitioners (NP). The object of this study was to evaluate the effect of CARA buprenorphine prescribing for OUD in Oregon.

Study Design: Using data from Oregon’s Prescription Drug Monitoring Program, we examined the effect of CARA enactment on buprenorphine prescribing using an interrupted time series design. We quantified changes in buprenorphine use between January 1, 2016 to December 31, 2018 overall, by provider type (NP vs MD/DO), and geography (rural, urban, frontier).

Results: Post CARA, the trend in buprenorphine use increased by 211 prescriptions per month (p=0.05). The percent attributed to waivered NPs increased by 0.7% per month (p

Conclusions: Buprenorphine dispensing rates in Oregon increased significantly following CARA implementation. The impact of adding NPs as authorized prescribers has enhanced access to buprenorphine prescriptions in rural and sparsely populated areas of the state where such patients were previously underserved.