Implementing buprenorphine for opioid use disorder in veterans health administration primary care: a qualitative analysis

作者：Aline Lott, Anissa N. Danner, Carol A. Malte, Hope Salameh, Diana Bachowski, Adam J. Gordon, Hildi Hagedorn, Madeline C. Frost, Emily C. Williams, Andrew J. Saxon, Ryan S. Trim, Eric J. Hawkins · 发表于：Addiction Science & Clinical Practice · 年份：2025 · DOI：10.1186/s13722-025-00568-9 · 被引用次数：6 · 研究领域：Health Policy Implementation Science、Opioid Use Disorder Treatment、Substance Abuse Treatment and Outcomes

BACKGROUND: Medications for opioid use disorder are evidence-based, guideline-recommended treatments. While buprenorphine can be prescribed in nonspecialized office-based settings, it is underutilized. Using a multifaceted implementation initiative, the Veterans Health Administration (VHA) sought to expand access to buprenorphine in nonspecialized office-based settings, including primary care clinics. The purpose of this qualitative evaluation was to assess and describe primary care clinicians' perspectives on delivering buprenorphine care during the first year of the initiative. METHODS: Using a snowball sampling approach, individualized emails were sent to primary care clinicians participating in a VHA initiative (n = 43) inviting them to be interviewed. Individual semi-structured interviews were conducted September 2019 through January 2020, and were audio-recorded, transcribed, and analyzed using thematic analysis. The Consolidated Framework for Implementation Research (CFIR), a meta-theoretical framework of five domains associated with successful adoption of interventions, was used to organize findings. RESULTS: Of 43 clinicians invited, 19 responded and were interviewed (44.2%). Findings represented two CFIR domains: Inner Setting and Characteristics of Individuals. For Inner Setting, three themes were identified as influencing implementation during the first year of the initiative. Clinicians reported a shared receptivity to implement buprenorphine, organizational supp...