A Questionnaire Study among General Practitioners: Experience with and Attitudes to Opioid Substitution Treatment

Overview

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.