The Next Step in Expanding Treatment of Opioid Use Disorder?

Discussion Tips

Opioid use disorder is an under-treated condition. Primary care offers a platform to expand treatment far beyond current utilization, but previous efforts to expand prescribing through increasing buprenorphine waivers has not optimized the system for a variety of other reasons.^2,3 Given this context, the authors of this study attempted to implement and evaluate a more complex intervention in hopes of increasing the utilization of buprenorphine.

Discussion Questions

• What question is asked by this study and why does it matter?

• How does this study advance beyond previous research and clinical practice on this topic?

• How strong is the study design for answering the question?

• What is a multi-level model? Are these statistical models common in primary care research? Why is it important that the authors used this type of model in this study?

• To what degree can the findings be accounted for by:

  • ∘ How clinics were selected, excluded, or lost to follow-up?

  • ∘ How the main variables were measured?

  • ∘ What the intervention group was compared to?

  • ∘ Confounding (false attribution of causality because 2 variables discovered to be associated actually are associated with a 3rd factor)?

  • ∘ Chance?

  • ∘ How missing data were dealt with in the study? Why is missing data important to consider?

  • ∘ How the findings were interpreted?

• What are the main study findings?

• How comparable is the study sample to similar patients in your practice or region? What is your judgment about the transportability of the findings?

• What contextual factors are important for interpreting the findings?

• How might this study change your practice? Policy? Education? Research?

• Who are the constituencies for the findings, and how might they be engaged in interpreting or using the findings?

• What are the next steps in interpreting or applying the findings?

• What researchable questions remain?