Limitations
OUD
EVENTS, EVENT
This study has several limitations. First, data on which clinicians had ever prescribed buprenorphine before the study start date are unknown. The adoption end point is, therefore, best interpreted as time-to-next-event analysis from the study start date, and the factors presented here represent HRs for this event as well as demonstrating an additive effect of the trial intervention on contagion of events. This may affect the social contagion analysis by hiding exposures that occurred between adopters before the study start date. The potential effect of these unknown data on the current study is tempered by data showing that the reported rates of buprenorphine use were low across all sites, at 0% to 2% per encounter with OUD, with most sites reporting 0% use.