Rural clinics significantly boost buprenorphine prescribing with support program

Background and goal: Despite the removal of the X-waiver requirement, which once restricted clinicians from prescribing buprenorphine for opioid use disorder (OUD), only a small percentage of primary care clinicians currently prescribe medication for OUD (MOUD). This study evaluated a structured support program to help small, rural primary care clinics improve their capacity to provide this treatment. 

Study approach: Researchers worked with 15 primary care practices in Colorado over a 12-month period from January 2022 through January 2023. The program provided clinics with monthly educational sessions, direct access to an addiction medicine specialist, and support from practice facilitators to achieve specific milestones in MOUD implementation.. The researchers measured changes in buprenorphine prescribing and milestone completion rates at baseline and at 12 months.

Main results:

• The average number of active buprenorphine prescriptions per clinic increased significantly from 2.1 in the three months preceding the intervention (baseline) to 11.3 at 13 months. 

• Clinic completion rates for MOUD implementation milestones also showed significant improvements:

  • Core Aim 1 ("Build Your Team"): Increased from 40% at the start of the program to 93% at 12 months

  • Core Aim 2 ("Engage and Support Patients"): Increased from 23% to 84%

  • Core Aim 3 ("Connect with Recovery Support Services"): Increased from 28% to 93%

Why it matters: The findings from this study highlight a potentially scalable and effective model to expand access to MOUD in rural communities, where treatment options for opioid use disorder are often limited.