Elizabeth M. Stone PhD , Fangzhou Xie MA , Jennifer Miles PhD , Hillary Samples PhD , Mark Olfson MD, MPH , Stephen Crystal PhD
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引用次数: 0
Abstract
Introduction
Elimination of the X-waiver, which required clinicians to complete additional registration to prescribe buprenorphine for opioid use disorder, removed one barrier to treatment. This study examined the association of the X-waiver elimination with buprenorphine dispensations by clinician specialty.
Methods
Using IQVIA Longitudinal Prescription data, patients with 15 or more days of dispensed buprenorphine supply each month from May 2021 to December 2024 were identified. Interrupted time series analyses (conducted in 2025) examined changes in monthly counts of clinicians associated with dispensations and patients, overall and stratified by clinician specialty.
Results
During the study period, 189,771 clinicians dispensed buprenorphine to 2,699,441 patients. X-waiver elimination was associated with significant increases in the number of clinicians associated with dispensed buprenorphine prescriptions overall (change in level= 1,626 clinicians; 95% CI=577, 2,674; p<0.01; change in slope: 15 clinicians per month, 95% CI=13, 18, p<0.001) and across all specialties. X-waiver elimination was associated with a decrease in the number of patients with buprenorphine dispensations in January 2023 overall (change in level= −24,104 patients; 95% CI= −40,010, −8,198; p<0.01) and from all clinician groups except behavioral health physicians. Decreasing monthly rates of patients with buprenorphine dispensed by behavioral health physicians slowed after X-waiver elimination; monthly rates of buprenorphine patients with dispensations from primary care providers increased after (versus before) the policy change.
Conclusions
Although the number of clinicians associated with dispensed buprenorphine prescriptions after X-waiver elimination increased across all clinician types, patient-level gains associated with X-waiver elimination were limited.
期刊介绍:
The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health.
Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.