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Influences Upon the Decision to Adapt Office-Based Buprenorphine Treatment in Rural Settings: A Qualitative Study

Award Number: R21DA045233
ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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PROJECT SUMMARY AND ABSTRACT Opioid use disorders (OUDs) are epidemic and on the rise in the United States and have fueled significant increases in unintentional overdose. Rural areas in the US in particular have experienced significantly higher rates of overdose, both fatal and non-fatal, relative to urban areas. Overall, opioid addiction takes a tremendous toll on rural areas as they are often underserved with respect to healthcare and social services. Thus, there is an urgent need to address the ongoing crisis of opioid addiction in rural America. One avenue for addressing the crisis is to ensure sufficient access to evidence-based treatments for opioid use disorder (OUD). Medication-assisted treatment (MAT) with buprenorphine provides an effective outpatient option that can be implemented in a range of settings, including primary care. We propose to conduct a qualitative study as a first step of a developmental formative evaluation to examine the current status of buprenorphine prescribing practices and accessibility in two states with highly rural populations, Arkansas (where there are low numbers of buprenorphine waivered physicians per capita) and Kentucky (where there is a higher number of waivered physicians per capita). This work is a crucial first step in order to develop a larger subsequent study in which we will test implementation strategies to increase the adoption of buprenorphine treatment in both states. We propose two aims: 1) to conduct interviews among DATA-waivered physicians in rural areas of Arkansas and Kentucky across a range of practice settings in order to examine the range of influences upon the decision to obtain the waiver to prescribe buprenorphine as well as the barriers and facilitators to providing buprenorphine treatment; 2) to conduct interviews with non- waivered primary care providers in high-overdose, rural areas in both states to explore the perceived barriers and facilitators to providing buprenorphine treatment in rural primary care settings and the acceptability of existing treatment models for these settings. An important aspect of the proposed study is the inclusion of two states in different stages of the opioid epidemic: Arkansas, where the burden of opioid related morbidity and mortality is not yet severe, and Kentucky, where morbidity and mortality resultant from opioid use have reached unprecedented levels. The proposed study is an important first step in understanding the current landscape of buprenorphine treatment in rural states such as Arkansas and Kentucky and has significant implications for other rural states in the south seeking to expand access to buprenorphine treatment.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2023 ( Subtotal = -$1,170 )
2023	2019	UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES	4301 W MARKHAM ST	LITTLE ROCK	AR	72205	PULASKI	USA	Drug Abuse and Addiction Research Programs	000	2	2/2/2023	NON-COMPETING CONTINUATION	-$1,170
														Subtotal = -$1,170

Issue Date FY: 2021 ( Subtotal = -$5,049 )
2021	2019	UNIVERSITY OF ARKANSAS SYSTEM	4301 W MARKHAM ST SLOT 812 BIO-MED BLDG 1 STE 102	LITTLE ROCK	AR	72205	PULASKI	USA	Drug Abuse and Addiction Research Programs	000	2	9/27/2021	NON-COMPETING CONTINUATION	-$5,049
														Subtotal = -$5,049

Issue Date FY: 2019 ( Subtotal = $188,548 )
2019	2019	UNIVERSITY OF ARKANSAS SYSTEM	4301 W MARKHAM ST SLOT 812 BIO-MED BLDG 1 STE 102	LITTLE ROCK	AR	72205	PULASKI	USA	Drug Abuse and Addiction Research Programs	000	2	5/17/2019	NON-COMPETING CONTINUATION	$188,548
														Subtotal = $188,548

Issue Date FY: 2018 ( Subtotal = $237,491 )
2018	2018	UNIVERSITY OF ARKANSAS SYSTEM	4301 W MARKHAM ST SLOT 812 BIO-MED BLDG 1 STE 102	LITTLE ROCK	AR	72205	PULASKI	USA	Drug Abuse and Addiction Research Programs	000	1	6/14/2018	NEW	$237,491
														Subtotal = $237,491

Grand Total All Awards = $419,820

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Influences Upon the Decision to Adapt Office-Based Buprenorphine Treatment in Rural Settings: A Qualitative Study

Award Number: R21DA045233

ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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