{"doi":"10.1093/haschl/qxad051","title":"The potential impact of clinical decision support on nonwaivered primary care clinicians’ prescribing of buprenorphine","abstract":"Abstract Elimination of the X-waiver increased potential buprenorphine prescribers 13-fold, but growth in prescribing will likely be much lower. We explored self-assessments of nonwaivered primary care clinicians (PCCs) for factors affecting their likelihood to prescribe buprenorphine were the X-waiver eliminated (since realized January 2023) and the potential impacts of a clinical decision-support (CDS) tool for opioid use disorder (OUD). Cross-sectional survey data were obtained between January 2021 and March 2022 from 305 nonwaivered PCCs at 3 health systems. Factors explored were patient requests for buprenorphine, PCC access to an OUD-CDS, and PCC confidence and abilities for 5 OUD-care activities. Relationships were described using descriptive statistics and odds ratios. Only 26% of PCCs were more likely to prescribe buprenorphine upon patient request, whereas 63% were more likely to prescribe with the OUD-CDS. PCC confidence and abilities for some OUD-care activities were associated with increased prescribing likelihood from patient requests, but none were associated with the OUD-CDS. The OUD-CDS may increase buprenorphine prescribing for PCCs less likely to prescribe upon patient request. Future research is needed to develop interventions that increase PCC buprenorphine prescribing. Clinical trial registration: ClinicalTrials.gov. Identifier: NCT04198428. Clinical trial name: Clinical Decision Support for Opioid Use Disorders in Medical Settings (Compute 2.0)","journal":"Health Affairs Scholar","year":2023,"id":388940,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9538,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT04198428"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":624519,"name":"Jacob L. Haapala","orcid":null,"position":1,"is_corresponding":false},{"id":918482,"name":"Stephanie Ann Hooker","orcid":"0000-0003-4222-7046","position":2,"is_corresponding":false},{"id":397833,"name":"Leif I. Solberg","orcid":"0000-0001-5509-1139","position":3,"is_corresponding":false},{"id":1158775,"name":"Caitlin M Borgert-Spaniol","orcid":"0000-0002-2654-3244","position":4,"is_corresponding":false},{"id":72929,"name":"Katrina M. Romagnoli","orcid":"0000-0001-8473-2126","position":5,"is_corresponding":false},{"id":777856,"name":"Clayton I. Allen","orcid":null,"position":6,"is_corresponding":false},{"id":918484,"name":"Lorraine D Tusing","orcid":"0000-0002-9091-8178","position":7,"is_corresponding":false},{"id":918481,"name":"Eric A. Wright","orcid":"0000-0003-1721-4104","position":8,"is_corresponding":false},{"id":317284,"name":"Irina V. Haller","orcid":"0000-0002-7704-2845","position":9,"is_corresponding":false},{"id":251002,"name":"Rebecca C. Rossom","orcid":"0000-0002-9531-914X","position":10,"is_corresponding":false},{"id":918483,"name":"Anthony W. Olson","orcid":"0000-0003-4026-4716","position":0,"is_corresponding":true}],"reference_count":27,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:18:22.323414Z","pmid":"38756745","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}