Physicians’ attitudes towards patients with substance-related disorders predict training needs in addiction medicine: challenges and opportunities for strengthening the global addiction medicine workforce

Abstract

Abstract Introduction Substance use disorders (SUD) are increasing in prevalence, and most physicians will encounter patients with SUD (PWSUD). As a result, the training of the global addiction workforce requires expansion. Two primary barriers to improving the quality and quantity of the global addiction workforce are healthcare providers' negative attitudes toward PWSUD and a lack of qualified addiction physicians. The authors are unaware of any published research on the association between these two barriers: a study that could help inform us about how to strengthen global addiction services through targeted medical training. Methods. The MCRS, measuring professionals' attitudes towards patients with SUD, and the AM-TNA, measuring perceived training needs and competence gaps, were used to study the association between attitudes and competence. We used Pearson correlation, multiple regression, and PROCESS path analysis in a cross-sectional study design in a convenience sample of addiction physicians trained in The Netherlands (Dutch)(N = 70) and in Lithuanian (Lithuania) (N = 75) to explore this association and a possible moderation effect of the Gender and Country of Origin variables among addiction caregivers. Results. We found a significant positive correlation between the total score of both scales: R = 0.537, p < 0.001. The MCRS predicted the three AM-TNA subscales significantly p < 0.001, and Gender did not influence the association between the two scales. The Country of Origin variable and its combination with the MCRS total score did strengthen the association between the MCRS and two AM-TNA subscales: medical- ( p < 0.001) and practical aspects of perceived addiction competence ( p < 0.05 ). Conclusions. Attitudes predict perceived training needs, meaning addiction physicians with positive attitudes are likelier to have and want better-developed addiction knowledge and skills. To improve addiction services, the in-tandem use of the MCRS and the AM-TNA could reveal specific SUD competence gaps and model the design of an integrated addiction training or intervention approach. Future research should focus on the longitudinal use of the combined scales, assess individual professionals’ progress, and compare and combine self-reported competencies and attitudes with validated external assessments of learning, attitudes, and self-efficacy.