Primary Care Training and Education in Addiction Medicine Fellowship: expanding the addiction medicine workforce

Abstract

Background

Primary care providers (PCPs) are well-suited to identify candidates for substance use disorder (SUD) treatment and to provide patients with necessary longitudinal services and support. However, training for PCPs on how to diagnose and treat SUD is often lacking. The Primary Care Training and Education in Addiction Medicine (PC-TEAM) program is a one-year in-person and virtual hybrid program that provides more than 50 h of training and focuses on SUD-specific content.

Methods

This article describes the PC-TEAM training program and presents baseline and post-fellowship data on enrolled fellows (n = 88) to evaluate program effectiveness including changes in participant attitudes, knowledge, and comfort level in treating substance use in the primary care setting. Area Deprivation Index (ADI) scores were calculated by practice location of fellows to determine disadvantage across census tract groups.

Results

Large effect sizes in fellows’ comfort levels were observed in caring for patients with SUDs and employing motivational interviewing for SUD (Cohen’s \(d\) = 1.1, 0.78, and 0.91, respectively). The knowledge exam indicated significant improvement across all measures from pre- to post-fellowship. Nearly one in three providers (28.4%) practiced in areas with the highest ADI score of 10 and 50% in areas with an ADI score of 8 or higher.

Conclusion

TNT Fellows experienced an increased overall knowledge and level of comfort in delivering treatment to individuals with SUDs. Fellows typically worked in underserved areas serving vulnerable populations. The PC-TEAM training program provides the opportunity to further develop skills related to evidence-based screening, assessment, and treatment of SUDs.