A Questionnaire
Study among General Practitioners: Experience with and Attitudes to
Opioid Substitution Treatment
Mravčík V.1, Coufalová M.1, Popov P.2, Zábranský T.3, Procházka R.4
1Národní monitorovací středisko pro drogy a drogové závislosti 2Odd. léčby závislostí VFN 3Hubert H. Humphrey fellow, Bloomberg School of Public Health, Johns Hopkins University & National Institute of Drug Abuse, USA 4praktický lékař, Praha |
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Summary:
General practitioners (GPs) in their surgeries and substitution treatment centres are the major
providers of opioid maintenance treatment in a number of European countries. Although in the
Czech Republic any GP has been allowed to prescribe buprenorphine (Subutex) since 2001, the
opioid substitution treatment provided by primary care professionals has not been the subject of
research to date.
Objective: To collect and analyze data on GPs’ experience gained with opioid maintenance treatment
in the Czech Reupblic, their attitudes and needs.
Method: A structured questionnaire was distributed via the Bulletin of the Association of General
Practitioners and district Association representatives. The validity of study results may be affected
by a low respondence rate (10 %) with 398 questionnaires only returned by mail.
Results: Twenty-eight (7%) GPs reported to have gained experience with buprenorphine which
was most frequently prescribed in the regions with the highest prevalence of heroin users, i.e. in
Prague and the Ústí nad Labem region (27 % and 12 %, respectively). Other regions, including wesbuprenortern
and southern Bohemia with relatively high prevalence of heroin users, showed lower buprenorphine
prescription rates (0–6 %). Most buprenorphine prescribers (78 %) rated their experience
as positive or highly positive. Availability and effectiveness were seen as the main pros of the
substitution treatment. One third of the GPs who have not prescribed opioid maintenance treatment
yet are considering doing so in the future. Greater awareness of drug abuse issues and availability
of methodical guidance and consulting in opioid substitution treatment are going to become
the most relevant factors in the future. Possible reportability of data on opioid maintenance
treatment to a central registry does not seem to be a major obstacle to implementing the substitution
treatment in the GPs’ surgeries. Decision makers should take advantage of the GPs’ potential
to promote the opioid maintenance treatment in the Czech Republic.
Key words:
opioid agonist treatment – maintenance treatment – methadone – buprenorphine – primary
health care – general practitioner.
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