ORIGINAL RESEARCH article
Front. Med.
Sec. Family Medicine and Primary Care
Factors influencing family physicians' willingness to prescribe opioid agonist therapy using virtual modalities: a qualitative analysis
Sarah Munoz-Violant 1
Sarah Spencer 1
Ellie Gooderham 1
Shawna Narayan 2
Bohdan Nosyk 1
Rita Katherine McCracken 1
Lindsay Hedden 1
1. Simon Fraser University, Burnaby, Canada
2. The University of British Columbia, Vancouver, Canada
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Abstract
Although opioid agonist therapy (OAT) is the first-line treatment for Opioid Use Disorder (OUD), access, initiation, and retention rates remain low. An avenue to improve these rates is to enhance OAT delivery in primary care settings. As Canada continues to support hybrid models combining in-person and virtual care, evaluating the role of virtual care in supporting OAT prescribing and OUD management is necessary. This qualitative study explores the factors enabling and hindering family physicians' willingness to prescribe OAT virtually. Utilizing maximum variation sampling, we conducted semi-structured interviews with 12 family physicians providing care to people with OUD in British Columbia, Canada. We audio-recorded, transcribed verbatim, coded, and thematically analyzed interview data using a hybrid inductive–deductive approach. In this focused analysis, we identified themes across patient-, physician-, and health system-level factors in accordance with the Barriers and/or Facilitators to Primary Care Access for Individuals with Mental Health and/or Substance Use Issues framework. Patients' individual characteristics, pre-existing patient-provider relationships, and physicians' perceptions of patient stability each influenced prescribing decisions in virtual modalities. Providing care alongside an interdisciplinary team and access to province-wide centralized patient data systems or medical support networks also impacted physicians' willingness to prescribe OAT virtually. This study highlights the key factors influencing physicians' willingness to prescribe OAT virtually and underscores the need for policy frameworks that empower providers to deliver equitable, patient-centred virtual care.
Summary
Keywords
Opioid Agonist Therapy, Opioid use disorder, prescribing, Primary Care, telehealth, Virtual care
Received
17 December 2025
Accepted
11 February 2026
Copyright
© 2026 Munoz-Violant, Spencer, Gooderham, Narayan, Nosyk, McCracken and Hedden. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Lindsay Hedden
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.