Medications for opioid use disorder (MOUD) remain highly inaccessible despite demonstrated effectiveness. We examine the extent of screening for opioid use and availability of MOUD in a national cross-section of multi-physician primary care and multispecialty practices. Drawing on an existing framework to characterize the internal and environmental context, we assess socio-technical, organizational-managerial, market-based, and state-regulation factors associated with the use of opioid screening and offering of MOUD in a practice. A total of 26.2% of practices offered MOUD, while 69.4% of practices screened for opioid use. Having advanced health information technology functionality was positively associated with both screening for opioid use and offering MOUD in a practice, while access to on-site behavioral clinicians was positively associated with offering MOUD in adjusted models. These results suggest that improving access to information and expertise may enable physician practices to respond more effectively to the nation's ongoing opioid epidemic.

中文翻译：

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医生实践使用阿片类药物使用障碍的筛查和药物的内部和环境预测因素。

尽管阿片类药物使用障碍 (MOUD) 的药物已被证明有效，但仍然很难获得。我们研究了全国多医生初级保健和多专科实践中阿片类药物使用的筛查范围和 MOUD 的可用性。我们利用现有框架来描述内部和环境背景，评估与在实践中使用阿片类药物筛选和提供 MOUD 相关的社会技术、组织管理、基于市场和国家监管的因素。共有 26.2% 的诊所提供 MOUD，而 69.4% 的诊所则筛查阿片类药物的使用情况。拥有先进的健康信息技术功能与阿片类药物使用筛查和实践中提供 MOUD 呈正相关，而与现场行为临床医生的接触与在调整后的模型中提供 MOUD 呈正相关。这些结果表明，改善信息和专业知识的获取可能使医生能够更有效地应对全国持续的阿片类药物流行病。