Association between tailored prescriber training and buprenorphine treatment for opioid use disorder among emergency medicine clinicians.

BACKGROUND

Buprenorphine, despite effectiveness as a medication for opioid use disorder (MOUD), remains underutilized in emergency departments (EDs), with few scalable, statewide programs to improve prescribing. This study evaluated whether a tailored, emergency medicine-specific training offered by the Overdose Prevention Engagement Network (OPEN) across Michigan increased buprenorphine prescribing.

METHODS

This pre-post cohort study compared 9-month periods before vs. after training using IQVIA dispensing data linked by National Provider Identifier (NPI) to participating clinicians. Eligible participants were ED clinicians attending a single, expert-led, incentivized OPEN training session (2020-2023). Clinician-level outcomes of buprenorphine prescription fills (primary), unique patients treated, and new patient initiations were analyzed using adjusted mixed model regression. Fills among non-participating ED clinicians were descriptively examined.

RESULTS

Among 203 ED clinicians, buprenorphine fills increased after training from 531 to 963 fills or from 2.6 to 4.7 fills/clinician (adjusted difference + 2.1 fills/clinician, 95% CI 0.9 to 3.3). Unique patients dispensed buprenorphine increased from 162 to 457 (adjusted difference + 1.5 patients/clinician, 95% CI 1.1 to 1.9), and new initiations increased from 53 to 222 (adjusted difference/clinician +0.8, 95% CI 0.6 to 1.0). Non-participants had 2.2 and 2.4 fills/clinician in pre- and post-training periods, respectively.

CONCLUSION

A tailored training session for MOUD prescribing for ED clinicians was associated with increased buprenorphine prescription fills, patients treated, and new initiations. These findings suggest that this scalable, low-resource approach to enhance prescriber skills in emergency care settings may inform state and national strategies to expand buprenorphine access as part of efforts to address the opioid crisis.