2024
Extended-Release 7-Day Injectable Buprenorphine for Patients With Minimal to Mild Opioid Withdrawal
D’Onofrio G, Herring A, Perrone J, Hawk K, Samuels E, Cowan E, Anderson E, McCormack R, Huntley K, Owens P, Martel S, Schactman M, Lofwall M, Walsh S, Dziura J, Fiellin D. Extended-Release 7-Day Injectable Buprenorphine for Patients With Minimal to Mild Opioid Withdrawal. JAMA Network Open 2024, 7: e2420702. PMID: 38976265, PMCID: PMC11231806, DOI: 10.1001/jamanetworkopen.2024.20702.Peer-Reviewed Original ResearchConceptsClinical Opiate Withdrawal ScaleExtended-release buprenorphineOpioid use disorderPrecipitated withdrawalOpioid withdrawalOpioid use disorder treatmentCow scoreClinical Opiate Withdrawal Scale scoreAdverse eventsNonrandomized trialsSevere opioid use disorderDays of opioid useOpiate Withdrawal ScaleModerate to severe opioid use disorderFormulation of buprenorphineOpioid use disorder careWithdrawal ScaleUse disorderAssociated with medicationsNonprescribed opioidsPain scoresExtended-releaseInjection painOpioid useAdult patientsFormative evaluation of an emergency department clinical decision support system for agitation symptoms: a study protocol
Wong A, Nath B, Shah D, Kumar A, Brinker M, Faustino I, Boyce M, Dziura J, Heckmann R, Yonkers K, Bernstein S, Adapa K, Taylor R, Ovchinnikova P, McCall T, Melnick E. Formative evaluation of an emergency department clinical decision support system for agitation symptoms: a study protocol. BMJ Open 2024, 14: e082834. PMID: 38373857, PMCID: PMC10882402, DOI: 10.1136/bmjopen-2023-082834.Peer-Reviewed Original ResearchConceptsComputerised clinical decision supportED treatRestraint useExperiences of restraint useMental health-related visitsEmergency departmentPrevent agitationSystems-related factorsImprove patient experienceClinical decision support systemsRegional health systemClinical decision supportDe-escalation techniquesRandomised controlled trialsFormative evaluationPeer-reviewed journalsBest-practice guidanceAt-risk populationsCDS toolsThematic saturationED cliniciansPatient experienceED sitesHealth systemED physicians
2022
Effect of Implementation Facilitation to Promote Adoption of Medications for Addiction Treatment in US HIV Clinics
Edelman EJ, Gan G, Dziura J, Esserman D, Porter E, Becker WC, Chan PA, Cornman DH, Helfrich CD, Reynolds J, Yager JE, Morford KL, Muvvala SB, Fiellin DA. Effect of Implementation Facilitation to Promote Adoption of Medications for Addiction Treatment in US HIV Clinics. JAMA Network Open 2022, 5: e2236904. PMID: 36251291, PMCID: PMC9577676, DOI: 10.1001/jamanetworkopen.2022.36904.Peer-Reviewed Original ResearchConceptsTobacco use disorderHIV clinicOpioid use disorderUse disordersAlcohol use disorderAddiction treatmentControl periodImplementation facilitationAdoption of medicationsMulticomponent implementation strategyProvision of MOUDUS HIV clinicsMaintenance periodElectronic health record dataHealth record dataEvaluation periodAdult patientsMean ageClinical trialsMAIN OUTCOMEClinicMOUDPatientsDisordersPatient incentivesUser centered clinical decision support to implement initiation of buprenorphine for opioid use disorder in the emergency department: EMBED pragmatic cluster randomized controlled trial
Melnick ER, Nath B, Dziura JD, Casey MF, Jeffery MM, Paek H, Soares WE, Hoppe JA, Rajeevan H, Li F, Skains RM, Walter LA, Patel MD, Chari SV, Platts-Mills TF, Hess EP, D'Onofrio G. User centered clinical decision support to implement initiation of buprenorphine for opioid use disorder in the emergency department: EMBED pragmatic cluster randomized controlled trial. The BMJ 2022, 377: e069271. PMID: 35760423, PMCID: PMC9231533, DOI: 10.1136/bmj-2021-069271.Peer-Reviewed Original ResearchConceptsOpioid use disorderUsual care armEmergency departmentUse disordersCare armPragmatic clusterClinical decision supportIntervention armRoutine emergency careSecondary implementation outcomesSeverity of withdrawalTertiary care centerClinical decision support toolInitiation of buprenorphineElectronic health record tasksElectronic health record workflowsRE-AIM frameworkElectronic health record platformsHealth record platformsClinical decision support systemElectronic health recordsVisit documentationTreatment of addictionUsual careAdult patientsAssociation of renalase with clinical outcomes in hospitalized patients with COVID-19
Safdar B, Wang M, Guo X, Cha C, Chun HJ, Deng Y, Dziura J, El-Khoury JM, Gorelick F, Ko AI, Lee AI, Safirstein R, Simonov M, Zhou B, Desir GV. Association of renalase with clinical outcomes in hospitalized patients with COVID-19. PLOS ONE 2022, 17: e0264178. PMID: 35259186, PMCID: PMC8903289, DOI: 10.1371/journal.pone.0264178.Peer-Reviewed Original ResearchConceptsCOVID-19 patientsRenalase levelsIntensive care unit admissionHospitalized COVID-19 patientsMean age 64 yearsCOVID-19Cox proportional hazards modelCare unit admissionPrimary composite outcomeRetrospective cohort studyUse of vasopressorsSevere COVID-19IL-6 levelsAge 64 yearsRisk of deathCOVID-19 subjectsInitial disease severityProportional hazards modelCOVID-19 diseasePlasma renalaseUnit admissionICU admissionCohort studyComposite outcomeCytokine levels
2021
Variations in Quality of Care by Sex and Social Determinants of Health Among Younger Adults With Acute Myocardial Infarction in the US and Canada
Raparelli V, Pilote L, Dang B, Behlouli H, Dziura JD, Bueno H, D’Onofrio G, Krumholz HM, Dreyer RP. Variations in Quality of Care by Sex and Social Determinants of Health Among Younger Adults With Acute Myocardial Infarction in the US and Canada. JAMA Network Open 2021, 4: e2128182. PMID: 34668947, PMCID: PMC8529414, DOI: 10.1001/jamanetworkopen.2021.28182.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionQuality of careHealth care systemYoung adultsFemale sexMyocardial infarctionCare systemHospital careSocial determinantsRetrospective cohort analysisLow qualityAdverse SDOHLowest tertileReadmission ratesMore patientsPostacute careAMI careOutpatient careCare scoresHigh prevalenceCohort analysisLarge cohortMAIN OUTCOMESDOHHospitalHigh-Dose Buprenorphine Induction in the Emergency Department for Treatment of Opioid Use Disorder
Herring AA, Vosooghi AA, Luftig J, Anderson ES, Zhao X, Dziura J, Hawk KF, McCormack RP, Saxon A, D’Onofrio G. High-Dose Buprenorphine Induction in the Emergency Department for Treatment of Opioid Use Disorder. JAMA Network Open 2021, 4: e2117128. PMID: 34264326, PMCID: PMC8283555, DOI: 10.1001/jamanetworkopen.2021.17128.Peer-Reviewed Original ResearchConceptsOpioid use disorderEmergency departmentBuprenorphine inductionRespiratory depressionAdverse eventsUse disordersUntreated opioid use disorderSerious adverse eventsFurther prospective investigationLength of stayUrban emergency departmentSafety-net hospitalAdvanced practice practitionersElectronic health recordsUnique cliniciansSublingual buprenorphineBuprenorphine doseED visitsED encountersCase seriesED patientsED physiciansSupplemental oxygenMedian lengthUnique patientsImplantable Cardioverter Defibrillator Lead Survival in Athletic Patients
Link MS, Sullivan RM, Olshansky B, Cannom D, Berul CI, Hauser RG, Heidbuchel H, Jordaens L, Krahn AD, Morgan J, Patton KK, Saarel EV, Wilkoff BL, Li F, Dziura J, Brandt C, Barth C, Lampert R. Implantable Cardioverter Defibrillator Lead Survival in Athletic Patients. Circulation Arrhythmia And Electrophysiology 2021, 14: e009344. PMID: 33724879, DOI: 10.1161/circep.120.009344.Peer-Reviewed Original ResearchAssociation of Race/Ethnicity and Other Demographic Characteristics With Use of Physical Restraints in the Emergency Department
Wong AH, Whitfill T, Ohuabunwa EC, Ray JM, Dziura JD, Bernstein SL, Taylor RA. Association of Race/Ethnicity and Other Demographic Characteristics With Use of Physical Restraints in the Emergency Department. JAMA Network Open 2021, 4: e2035241. PMID: 33492372, PMCID: PMC7835716, DOI: 10.1001/jamanetworkopen.2020.35241.Peer-Reviewed Original Research
2020
Posttraumatic Stress Disorder, Antidepressant Use, and Hemorrhagic Stroke in Young Men and Women
Gaffey AE, Rosman L, Burg MM, Haskell SG, Brandt CA, Skanderson M, Dziura J, Sico JJ. Posttraumatic Stress Disorder, Antidepressant Use, and Hemorrhagic Stroke in Young Men and Women. Stroke 2020, 52: 121-129. PMID: 33297868, PMCID: PMC7770089, DOI: 10.1161/strokeaha.120.030379.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderHemorrhagic strokeHealth care utilizationUse of SSRIsGreater riskSSRI useStroke riskCare utilizationStress disorderEffects of PTSDIncident hemorrhagic strokeMiddle-aged veteransModifiable risk factorsNon-pharmacological treatmentMultivariate Cox modelNorepinephrine reuptake inhibitorsOverall incidence rateHemorrhagic stroke riskSNRI useIncident strokeAntidepressant useReuptake inhibitorsComorbid conditionsLifestyle factorsPsychiatric comorbidityImmune responses to SARS-CoV-2 infection in hospitalized pediatric and adult patients
Pierce CA, Preston-Hurlburt P, Dai Y, Aschner CB, Cheshenko N, Galen B, Garforth SJ, Herrera NG, Jangra RK, Morano NC, Orner E, Sy S, Chandran K, Dziura J, Almo SC, Ring A, Keller MJ, Herold KC, Herold BC. Immune responses to SARS-CoV-2 infection in hospitalized pediatric and adult patients. Science Translational Medicine 2020, 12: eabd5487. PMID: 32958614, PMCID: PMC7658796, DOI: 10.1126/scitranslmed.abd5487.Peer-Reviewed Original ResearchConceptsImmune responsePediatric patientsAntibody titersAdult patientsSerum concentrationsT cellsSevere acute respiratory syndrome coronavirus 2IFN-γ serum concentrationsAcute respiratory syndrome coronavirus 2Robust T cell responsesSARS-CoV-2 infectionAntibody-dependent cellular phagocytosisRespiratory syndrome coronavirus 2Frequency of IFNMultisystem inflammatory syndromeT cell responsesCellular immune responsesSyndrome coronavirus 2Adaptive immune responsesAntiviral immune responseTumor necrosis factorMetropolitan hospital systemCoronavirus disease 2019COVID-19Age-dependent factorsValidating Self‐Reported Unhealthy Alcohol Use With Phosphatidylethanol (PEth) Among Patients With HIV
Eyawo O, Deng Y, Dziura J, Justice AC, McGinnis K, Tate JP, Rodriguez‐Barradas M, Hansen NB, Maisto SA, Marconi VC, O’Connor P, Bryant K, Fiellin DA, Edelman EJ. Validating Self‐Reported Unhealthy Alcohol Use With Phosphatidylethanol (PEth) Among Patients With HIV. Alcohol Clinical And Experimental Research 2020, 44: 2053-2063. PMID: 33460225, PMCID: PMC8856627, DOI: 10.1111/acer.14435.Peer-Reviewed Original ResearchConceptsUnhealthy alcohol useSignificant alcohol useHeavy drinking daysAlcohol use disorderTimeline FollowbackAlcohol useSelf-reported alcohol useNumber of drinksClinical trialsRisk drinkingUse disordersDrinking daysBiomarker-based evidenceSample of PWHDrinks/dayMean numberSelf-reported alcohol consumptionMagnitude of associationBlood spot samplesLiver diseasePEth levelsTLFB interviewAlcohol consumptionLogistic regressionPatientsAll-cause mortality among males living with and without HIV initiating long-term opioid therapy, and its association with opioid dose, opioid interruption and other factors
Gordon K, Manhapra A, Crystal S, Dziura J, Edelman E, Skanderson M, Kerns R, Justice A, Tate J, Becker W. All-cause mortality among males living with and without HIV initiating long-term opioid therapy, and its association with opioid dose, opioid interruption and other factors. Drug And Alcohol Dependence 2020, 216: 108291. PMID: 33011662, PMCID: PMC7644145, DOI: 10.1016/j.drugalcdep.2020.108291.Peer-Reviewed Original ResearchConceptsMorphine equivalent daily doseCause mortalityLong-term opioid therapyTime-updated Cox regressionStrong dose-response relationshipUnnatural deathsEquivalent daily doseDose-response relationshipOpioid doseOpioid therapyUninfected patientsOpioid useDaily doseCox regressionMortality outcomesTherapy doseHigh doseMale veteransOverdose fatalitiesOverdose mortalityPLWHMortalityHIVPatientsDoseIncident Musculoskeletal Conditions Among Men and Women Veterans Returning From Deployment
Haskell SG, Brandt C, Bastian L, Driscoll M, Bathulapalli H, Dziura J. Incident Musculoskeletal Conditions Among Men and Women Veterans Returning From Deployment. Medical Care 2020, 58: 1082-1090. PMID: 32925458, DOI: 10.1097/mlr.0000000000001403.Peer-Reviewed Original ResearchConceptsMSK conditionsAnkle/footVeterans AffairsUpper extremityMen veteransClinical Modification diagnostic codesPercent of womenOperation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn VeteransMSK diagnosesCohort studyNinth RevisionUnadjusted ratesMusculoskeletal conditionsDiagnostic codesIncidence rateOperation New Dawn veteransFirst visitMusculoskeletal injuriesNew Dawn veteransInternational ClassificationWomen veteransLast deploymentWomenVeteransMenTrial study design to test a bilingual digital health tool for alcohol use disorders among Latino emergency department patients
Vaca FE, Dziura J, Abujarad F, Pantalon MV, Hsiao A, Field CA, D'Onofrio G. Trial study design to test a bilingual digital health tool for alcohol use disorders among Latino emergency department patients. Contemporary Clinical Trials 2020, 96: 106104. PMID: 32777381, PMCID: PMC8252296, DOI: 10.1016/j.cct.2020.106104.Peer-Reviewed Original ResearchConceptsAlcohol use disorderBrief interventionSevere alcohol use disorderUse disordersBinge drinking daysSpecialized treatment servicesAlcohol-related health disparitiesAlcohol screeningBrief intervention toolTimeline followback methodHigh-risk drinkingNegative behaviorsTreatment engagementAUD severityImpaired driversStandard careDrinking daysMeaningful contactIntervention toolDigital health toolsUnhealthy drinkingPrimary outcomeLatino patientsHealth toolsWork/schoolInterrupted Time Series of User‐centered Clinical Decision Support Implementation for Emergency Department–initiated Buprenorphine for Opioid Use Disorder
Holland WC, Nath B, Li F, Maciejewski K, Paek H, Dziura J, Rajeevan H, Lu CC, Katsovich L, D'Onofrio G, Melnick ER. Interrupted Time Series of User‐centered Clinical Decision Support Implementation for Emergency Department–initiated Buprenorphine for Opioid Use Disorder. Academic Emergency Medicine 2020, 27: 753-763. PMID: 32352206, PMCID: PMC7496559, DOI: 10.1111/acem.14002.Peer-Reviewed Original ResearchConceptsOpioid use disorderComputerized clinical decision support systemsRates of EDBUP initiationUse disordersClinical decision support implementationEmergency department initiationRoutine emergency careInterrupted time series studyAdult ED patientsInterrupted time seriesClinical decision support systemElectronic health recordsClinicians' unfamiliarityED initiationDecision support implementationED dischargeOpioid withdrawalSecondary outcomesOngoing trialsPrimary outcomeAcademic EDED patientsSingle EDUnique patientsAssociation of prescription opioids and incident cardiovascular risk factors among post-9/11 Veterans
Chui PW, Gordon KS, Dziura J, Burg MM, Brandt CA, Sico JJ, Leapman MS, Cavanagh CE, Rosman L, Haskell S, Becker WC, Bastian LA. Association of prescription opioids and incident cardiovascular risk factors among post-9/11 Veterans. Preventive Medicine 2020, 134: 106036. PMID: 32097753, DOI: 10.1016/j.ypmed.2020.106036.Peer-Reviewed Original ResearchConceptsCVD risk factorsLong-term opioid therapyCurrent smoking statusRisk factorsOpioid useOpioid therapySmoking statusCardiovascular diseaseHigh riskLong-term exposureIncident cardiovascular risk factorsModifiable CVD risk factorsPrevalent CVD risk factorsFirst primary care visitCardiovascular risk factorsPrimary care visitsBaseline periodElectronic health record dataMain outcome measuresHealth record dataOpioid prescriptionsCare visitsPrescription opioidsMain exposureOutcome measures
2019
Posttraumatic Stress Disorder and Risk for Stroke in Young and Middle-Aged Adults
Rosman L, Sico JJ, Lampert R, Gaffey AE, Ramsey CM, Dziura J, Chui PW, Cavanagh CE, Brandt C, Haskell S, Burg MM. Posttraumatic Stress Disorder and Risk for Stroke in Young and Middle-Aged Adults. Stroke 2019, 50: 2996-3003. PMID: 31619151, DOI: 10.1161/strokeaha.119.026854.Peer-Reviewed Original ResearchConceptsTransient ischemic attackIncident transient ischemic attackPosttraumatic stress disorderEffects of PTSDIschemic strokeIncident strokeHealthcare utilizationIncidence of TIAStress disorderYoung adultsMiddle-aged veteransStroke risk factorsMultivariate Cox modelIschemic stroke riskAge-specific prevention strategiesVeterans Health AdministrationMiddle-aged adultsIschemic attackStroke riskPsychological factorsUnadjusted analysesRisk factorsEffect modificationCox modelPsychiatric disordersPosttraumatic Stress Disorder and Risk for Early Incident Atrial Fibrillation: A Prospective Cohort Study of 1.1 Million Young Adults
Rosman L, Lampert R, Ramsey CM, Dziura J, Chui PW, Brandt C, Haskell S, Burg MM. Posttraumatic Stress Disorder and Risk for Early Incident Atrial Fibrillation: A Prospective Cohort Study of 1.1 Million Young Adults. Journal Of The American Heart Association 2019, 8: e013741. PMID: 31564191, PMCID: PMC6806049, DOI: 10.1161/jaha.119.013741.Peer-Reviewed Original ResearchConceptsIncident atrial fibrillationPosttraumatic stress disorderMiddle-aged veteransAtrial fibrillationRisk factorsMultivariate Cox proportional hazards modelIncidence of AFCox proportional hazards modelStress disorderAF risk factorsCardiovascular risk factorsNew atrial fibrillationProspective cohort studyHigher overall incidenceVeterans Health AdministrationProportional hazards modelAcute psychological stressChronic stress syndromeCohort studyOverall incidenceAtrial tachycardiaLifestyle factorsAtrial flutterHealthcare useEffect modificationIntegrated stepped alcohol treatment for patients with HIV and liver disease: A randomized trial
Edelman EJ, Maisto SA, Hansen NB, Cutter CJ, Dziura J, Deng Y, Fiellin LE, O'Connor PG, Bedimo R, Gibert CL, Marconi VC, Rimland D, Rodriguez-Barradas MC, Simberkoff MS, Tate JP, Justice AC, Bryant KJ, Fiellin DA. Integrated stepped alcohol treatment for patients with HIV and liver disease: A randomized trial. Journal Of Substance Use And Addiction Treatment 2019, 106: 97-106. PMID: 31540617, PMCID: PMC7244228, DOI: 10.1016/j.jsat.2019.08.007.Peer-Reviewed Original Research