Buprenorphine Treatment Characteristics and Practices Among Physicians Across Locations of Practice
| Large Metropolitan Area | Small Metropolitan Area | Nonmetropolitan Area | N | χ2 or F | P Value | |
|---|---|---|---|---|---|---|
| New patients, in-office induction, mean % (SD) | 43.2 (41.9) | 47.0 (42.2) | 47.5 (41.4) | 1,141 | 1.23 | .29 |
| New patients, at-home induction, mean % (SD) | 37.1 (41.6) | 35.2 (41.3) | 28.3 (38.4) | 1,137 | 2.46 | .09 |
| New patients already using street buprenorphine, mean % (SD) | 19.2 (23.2)a,b | 23.7 (24.4) | 25.0 (26.2) | 1,136 | 6.05 | .002 |
| Patients in past year with heroin use disorder, mean % (SD) | 26.5 (23.5)a,b | 20.4 (20.1) | 17.9 (20.8) | 1,135 | 13.41 | <.001 |
| Patients in past year with prescription opioid use disorder, mean % (SD) | 51.9 (27.2)a,b | 57.1 (27.0) | 60.0 (27.4) | 1,134 | 7.30 | <.001 |
| Patients in past year with both heroin and prescription opioid use disorders, mean % (SD) | 22.7 (19.7) | 22.1 (19.5) | 24.7 (22.2) | 1,133 | 0.82 | .44 |
| Typical frequency of office visits in initial treatment (ie, first 60 days), No. (%) | 1,131 | |||||
| ≥Every week | 149 (23.4) | 121 (32.9) | 31 (24.8) | 12.95 | .012 | |
| Every 2 weeks | 246 (38.6) | 112 (30.4) | 43 (34.4) | |||
| ≤Once a month | 243 (38.1) | 135 (36.7) | 51 (40.8) | |||
| Typical frequency of office visits in maintenance treatment (ie, after 60 days) for stable patients, No. (%) | 1,127 | 2.32 | .68 | |||
| ≥Every 2 weeks | 93 (14.7) | 65 (17.7) | 18 (14.4) | |||
| Once a month | 473 (74.5) | 260 (70.8) | 91 (72.8) | |||
| ≤Every 2 months | 69 (10.9) | 42 (11.4) | 16 (12.8) | |||
| Typical visit frequency in maintenance treatment for unstable patients (eg, continued opioid use, misusing benzodiazepines), No. (%) | 1,130 | 5.12 | .53 | |||
| Every week | 239 (37.6) | 151 (41.0) | 50 (39.7) | |||
| Every 2 weeks | 258 (40.6) | 136 (37.0) | 41 (32.5) | |||
| ≤Once a month | 105 (16.5) | 58 (15.8) | 27 (21.4) | |||
| Patient would no longer be seen | 34 (5.3) | 23 (6.3) | 8 (6.3) | |||
| Typical buprenorphine dose for stable patients in maintenance treatment, No. (%) | 1,115 | 11.46 | .08 | |||
| ≤8 mg | 188 (30.0) | 104 (28.7) | 31 (24.6) | |||
| 9-12 mg | 182 (29.0) | 78 (21.5) | 36 (28.6) | |||
| 14-16 mg | 230 (36.7) | 161 (44.5) | 50 (39.7) | |||
| >16 mg | 27 (4.3) | 19 (5.2) | 9 (7.1) | |||
| Maximum buprenorphine dose for stable patients in maintenance treatment, No. (%) | 1,102 | 5.76 | .45 | |||
| <16 mg | 78 (12.5) | 35 (9.8) | 19 (15.3) | |||
| 16 mg | 204 (32.8) | 123 (34.6) | 43 (34.7) | |||
| 17-24 mg | 263 (42.3) | 156 (43.8) | 43 (34.7) | |||
| >24 mg | 77 (12.4) | 42 (11.8) | 19 (15.3) |
Note: Comparisons were made using χ2 tests or 1-way analysis of variance (F statistic). Not all prescribers responded to all items; the N column represents the number of prescribers with valid data for each item.
↵a Significant difference with Bonferroni correction between physicians in large metropolitan areas and small metropolitan areas.
↵b Significant difference with Bonferroni correction between physicians in large metropolitan areas and nonmetropolitan areas.