DNP Scholarly Projects

Abstract

Background: Buprenorphine, an underutilized pharmacotherapy, can play a key role in closing the substantial opioid use disorder (OUD) treatment gap in the United States. Although 2016 US legislation authorized trained nurse practitioners (NPs) to obtain the Drug Enforcement Agency waiver to prescribe buprenorphine for OUD, many NPs do not have the waiver, and a large proportion of waivered NPs do not prescribe to capacity. Purpose: To identify the therapeutic commitment of Maine NPs to OUD as well as understand why Maine NPs do not adopt and utilize buprenorphine for the treatment of OUD. Review of Evidence: Commitment to OUD and adoption of buprenorphine in clinical practice is influenced by factors such as professional support and education. Few studies have examined NP commitment to OUD and adoption of buprenorphine. Project Design: A cross-sectional, Web-based survey measured the therapeutic commitment of Maine NPs to OUD with the Drug and Drug Problems Perceptions Questionnaire. Resources were identified that would encourage those without the buprenorphine waiver to obtain it and those with the waiver to accept more patients. Methods: The online survey was delivered to a convenience sample of NPs in Maine (N=299) in fall 2018. Results: Maine NPs have a moderately high degree of overall therapeutic commitment to OUD. Maine NPs in rural (p=.018) and urban (p=.024) practice settings and those with the buprenorphine waiver (p<.001) had significantly higher overall therapeutic commitment scores than their suburban and non-waivered NP counterparts. Professional support and education were priority resources to increase buprenorphine adoption and utilization. Conclusion: To facilitate NP commitment to OUD as well as NP adoption and utilization of buprenorphine, a comprehensive approach with special emphasis on professional support and education is warranted.

Date

4-22-2019

First Advisor

Dr. Linda Wofford

Scholarly Project Team Member

Dr. Laura Gray

Scholarly Project Team Member

Dr. David Phillippi

Scholarly Project Team Member

Dr. Kelley Strout

Department

Nursing, School of

College

Health Sciences & Nursing, Gordon E. Inman College of

Document Type

Scholarly Project

Degree

Doctorate of Nursing Practice (DNP)

Degree Level

Doctoral

Degree Grantor

Belmont University

Keywords

DDPPQ, therapeutic commitment, nurse practitioner, opioid use disorder, buprenorphine

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