LAUSR

Objectives Primary care providers (PCPs) prescribe medication for opioid use disorder (MOUD), but patients may receive MOUD from a provider who only prescribes MOUD, and who does not provide routine medical care that would be expected from a PCP. The importance of receiving MOUD from one’s own PCP versus another provider on patient MOUD retention is not known. Methods All patients receiving MOUD from December 2016 through November 2019 within a rural, Federally Qualified Health Center were included. Patient sociodemographic, PCP-MOUD concordance, and retention time in MOUD were extracted from the electronic health record. Travel-time from patients’ home to the clinic where MOUD was provided was calculated. The risk of premature discontinuation was estimated with Kaplan-Meier curves and with hazard ratios (HR) with 95% confidence intervals (CI). All analyses were performed using R version 3.4.4. Results Among (n = 353) patients receiving MOUD from 2016 to 2019, n = 77 (21.8%) patients receivedMOUD from their PCP (PCP-MOUD concordance). PCP-MOUD concordance was associated with reduced risk of premature discontinuation (HR = 0.41, 95% CI = 0.18–0.95), however, after multivariable adjustment, PCP-MOUD concordance was not significant (HR = 0.45, 95% CI = 0.19–1.05). Conclusions In this rural Federally Qualified Health Center, MOUD provision by a patient's own PCP, as compared to a separate provider, did not reach statistical significance for an association with improved retention in treatment. These findings are likely due to a small sample size, and support expanding buprenorphine access as part of comprehensive primary care to combat the opioid crisis, especially in rural areas.