Lindsey K Jennings1, Carolyn Bogan2, Jenna J McCauley3, Angela Moreland4, Suzanne Lane5, Ralph Ward6, Karen J Hartwell7, Louise Haynes8, Kathleen T Brady9. 1. Medical University of South Carolina, Department of Emergency Medicine, 169 Ashley Avenue, MSC 300, Charleston, SC 29425, USA. Electronic address: jennil@musc.edu. 2. Medical University of South Carolina, Department of Psychiatry and Behavioral Science, Addiction Sciences Division, 67 President Street, MSC 861, Charleston, SC 29425, USA. Electronic address: bogdon@musc.edu. 3. Medical University of South Carolina, Department of Psychiatry and Behavioral Science, Addiction Sciences Division, 100 Doughty St, MSC 861, Room BA228, Charleston, SC 29425, USA. Electronic address: mccaule@musc.edu. 4. Medical University of South Carolina, Department of Psychiatry and Behavioral Science, 100 Doughty St, MSC 861, Room BA232, Charleston, SC 29425, USA. Electronic address: moreland@musc.edu. 5. Medical University of South Carolina, Department of Psychiatry and Behavioral Science, Addiction Sciences Division, 67 President Street, MSC 861, Room 561N, Charleston, SC 29425, USA. Electronic address: lanesu@musc.edu. 6. Medical University of South Carolina, Department of Public Health Sciences, 35 Cannon Street, Room CS 302F, Charleston, SC 29425, USA. Electronic address: wardrc@musc.edu. 7. Medical University of South Carolina, Department of Psychiatry and Behavioral Science, Addiction Sciences Division, 67 President Street, MSC 861, Room 469N, USA. Electronic address: hartwellk@musc.edu. 8. Medical University of South Carolina, Department of Psychiatry and Behavioral Science, Addiction Sciences Division, 67 President Street, MSC 861, Room 559N, Charleston, SC 29425, USA. Electronic address: hayneslf@musc.edu. 9. Medical University of South Carolina, Department of Psychiatry and Behavioral Science, Addiction Sciences Division, 125 Doughty Street, Suite 140, Charleston, SC 29425, USA. Electronic address: bradyk@musc.edu.
Abstract
BACKGROUND: Emergency department-initiated buprenorphine (EDIB) programs have been shown to improve treatment outcomes for patients with opioid use disorders (OUD); however, little is known about how EDIB implementation impacts the patient census at participating hospitals. OBJECTIVES: To determine if implementation of an EDIB program was associated with changes in the number of patients presenting to the ED seeking treatment for substance use disorder (SUD). METHODS: We conducted a retrospective evaluation at a single academic ED that began offering EDIB in December 2017. Data span the period of December 2016 to April 2019, All ED visits with a chief complaint of addiction problem, detoxification, drug/alcohol assessment, drug problem, or withdrawal charted by nursing at the time of triage were eligible for inclusion. Charts were reviewed to determine: (1) treatment status and (2) substance(s) for which the patient was seeking treatment. An interrupted time series analysis was used to compare the pre- and post-EDIB rates for all-substance, as well as opioid-specific, treatment-seeking visits. RESULTS: For all-substance visits, the predicted level change in the treatment-seeking rate after EDIB was implemented was positive but not significant (0.000497, p = 0.53); the trend change after EDIB was also not significant (-0.00004, p = 0.73). For visits involving opioids, the predicted level change was (0.000638, p = 0.21); and the trend change was (0.000047, p = 0.49). CONCLUSION: Implementation of an EDIB program was not associated with increased rates of presentation by patients requesting treatment for a substance use disorder in the participating ED setting.
BACKGROUND: Emergency department-initiated buprenorphine (EDIB) programs have been shown to improve treatment outcomes for patients with opioid use disorders (OUD); however, little is known about how EDIB implementation impacts the patient census at participating hospitals. OBJECTIVES: To determine if implementation of an EDIB program was associated with changes in the number of patients presenting to the ED seeking treatment for substance use disorder (SUD). METHODS: We conducted a retrospective evaluation at a single academic ED that began offering EDIB in December 2017. Data span the period of December 2016 to April 2019, All ED visits with a chief complaint of addiction problem, detoxification, drug/alcohol assessment, drug problem, or withdrawal charted by nursing at the time of triage were eligible for inclusion. Charts were reviewed to determine: (1) treatment status and (2) substance(s) for which the patient was seeking treatment. An interrupted time series analysis was used to compare the pre- and post-EDIB rates for all-substance, as well as opioid-specific, treatment-seeking visits. RESULTS: For all-substance visits, the predicted level change in the treatment-seeking rate after EDIB was implemented was positive but not significant (0.000497, p = 0.53); the trend change after EDIB was also not significant (-0.00004, p = 0.73). For visits involving opioids, the predicted level change was (0.000638, p = 0.21); and the trend change was (0.000047, p = 0.49). CONCLUSION: Implementation of an EDIB program was not associated with increased rates of presentation by patients requesting treatment for a substance use disorder in the participating ED setting.
Authors: Marc R Larochelle; Dana Bernson; Thomas Land; Thomas J Stopka; Na Wang; Ziming Xuan; Sarah M Bagley; Jane M Liebschutz; Alexander Y Walley Journal: Ann Intern Med Date: 2018-06-19 Impact factor: 25.391
Authors: Gail D'Onofrio; Patrick G O'Connor; Michael V Pantalon; Marek C Chawarski; Susan H Busch; Patricia H Owens; Steven L Bernstein; David A Fiellin Journal: JAMA Date: 2015-04-28 Impact factor: 56.272
Authors: Callan Elswick Fockele; Herbert C Duber; Brad Finegood; Sophie C Morse; Lauren K Whiteside Journal: J Am Coll Emerg Physicians Open Date: 2021-03-23