2024
W81 Implementation Facilitation Improves Clinician Readiness to Provide Emergency Department-Initiated Buprenorphine in Four Urban Academic Centers
Hawk K, D'Onofrio G, Chawarski M, Coupet E, Cowan E, Curry L, Freiermurth C, Lyons M, Murphy A, O'Connor P, Richardson L, Rothman R, Whiteside L, Williams J, Fiellin D, Edelman E. W81 Implementation Facilitation Improves Clinician Readiness to Provide Emergency Department-Initiated Buprenorphine in Four Urban Academic Centers. Drug And Alcohol Dependence 2024, 260: 110699. DOI: 10.1016/j.drugalcdep.2023.110699.Peer-Reviewed Original ResearchT50 Receipt of Prescribed Opioids and Benzodiazepines After Non-Fatal Overdose and Risk of Subsequent Overdose
Howell B, Black A, Lin H, Lauretta G, Heimer R, Hawk K, D'Onofrio G, Fiellin D, Becker W. T50 Receipt of Prescribed Opioids and Benzodiazepines After Non-Fatal Overdose and Risk of Subsequent Overdose. Drug And Alcohol Dependence 2024, 260: 110499. DOI: 10.1016/j.drugalcdep.2023.110499.Peer-Reviewed Original ResearchExtended-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 patientsUsing qualitative system dynamics modeling to understand overdose bystander behavior in the context of Connecticut’s Good Samaritan Laws and identify effective policy options
Thompson R, Sabounchi N, Ali S, Heimer R, D’Onofrio G, Heckmann R. Using qualitative system dynamics modeling to understand overdose bystander behavior in the context of Connecticut’s Good Samaritan Laws and identify effective policy options. Harm Reduction Journal 2024, 21: 124. PMID: 38937759, PMCID: PMC11210010, DOI: 10.1186/s12954-024-00990-3.Peer-Reviewed Original ResearchConceptsSamaritan lawsGood Samaritan lawsBystander behaviorGroup model buildingFear of legal consequencesKnowledge of protectionResponses to opioid overdosesCriminal liabilityDrug arrestsLegal consequencesLaw enforcementNaloxone useLawStakeholder-engaged processOpioid overdoseHealth care providersFatal opioid overdoseSustainable system changeOpioid-related outcomesBystander experiencesSamaritanCare providersHarm reductionPotential bystandersPolicy determinationTrends in the Prescribing of Buprenorphine for Opioid Use Disorder, 2019-2023
Savitz S, Stevens M, Nath B, D’Onofrio G, Melnick E, Jeffery M. Trends in the Prescribing of Buprenorphine for Opioid Use Disorder, 2019-2023. Mayo Clinic Proceedings Innovations Quality & Outcomes 2024, 8: 308-320. PMID: 38841599, PMCID: PMC11152959, DOI: 10.1016/j.mayocpiqo.2024.04.004.Peer-Reviewed Original ResearchOpioid use disorderTreat alcohol use disorderAlcohol use disorderUse disorderX-waiverMedicare Advantage enrolleesTreat opioid use disorderRate ratiosEvaluate trendsPrescribing of buprenorphineOptumLabs Data WarehouseDaily doseCommercial enrolleesCoronavirus diseasePrescription fillsBuprenorphineDays supplyBuprenorphine prescribingFilling patternBuprenorphine accessImprove buprenorphine accessStudy periodResponse to coronavirus diseasePrescriber typePrescribingPrescription Opioid Dose Change Prior to Fatal Opioid-Detected Overdose.
Kazemitabar M, Howell B, Becker W, Lin H, Grau L, Heimer R, D'Onofrio G, Hawk K, Fiellin D, Black A. Prescription Opioid Dose Change Prior to Fatal Opioid-Detected Overdose. Journal Of Studies On Alcohol And Drugs 2024 PMID: 38775307, DOI: 10.15288/jsad.24-00026.Peer-Reviewed Original ResearchPrescribed opioidsOpioid dose changesRapid dose increaseNon-HispanicOverdose deathsToxicological resultsNon-prescription opioidsBlack non-HispanicMorphine equivalentsOpioid therapyWhite non-HispanicDose changesDaily doseMean ageDispensed opioidsPrescription opioidsPrescribing patternsOpioidDose increaseOpioid overdose crisisIncreasing dosesStudy investigated patternsEffect of timeEffects of ageSecondary analysisAssociation of marital/partner status with hospital readmission among young adults with acute myocardial infarction.
Zhu C, Dreyer R, Li F, Spatz E, Caraballo C, Mahajan S, Raparelli V, Leifheit E, Lu Y, Krumholz H, Spertus J, D'Onofrio G, Pilote L, Lichtman J. Association of marital/partner status with hospital readmission among young adults with acute myocardial infarction. PLOS ONE 2024, 19: e0287949. PMID: 38277368, PMCID: PMC10817183, DOI: 10.1371/journal.pone.0287949.Peer-Reviewed Original ResearchConceptsMarital/partner statusPsychosocial factorsAcute myocardial infarctionYoung adultsHospital dischargeYear of hospital dischargeYoung acute myocardial infarctionAssociated with 1.3-foldCohort of young adultsLong-term readmissionCox proportional hazards modelsStatus interactionSimilar-aged menMyocardial infarctionProportional hazards modelUnpartnered statusPatient interviewsPhysician panelCardiovascular healthHospital readmissionSocioeconomic factorsAMI survivorsSequential adjustmentCardiac readmissionMultiple imputationRenalase Identified by Machine Learning Methods as A Novel Independent Predictor of Mortality in Hospitalized Patients with COVID-19
Safdar B, Sobiesk M, Bertsimas D, Nowroozpoor A, Deng Y, D’Onofrio G, Dziura J, El-Khoury J, Guo X, Simonov M, Taylor R, Wang M, Desir G. Renalase Identified by Machine Learning Methods as A Novel Independent Predictor of Mortality in Hospitalized Patients with COVID-19. Journal Of Biotechnology And Biomedicine 2024, 07 DOI: 10.26502/jbb.2642-91280139.Peer-Reviewed Original Research
2023
Receipt of opioid use disorder treatments prior to fatal overdoses and comparison to no treatment in Connecticut, 2016–17
Heimer R, Black A, Lin H, Grau L, Fiellin D, Howell B, Hawk K, D'Onofrio G, Becker W. Receipt of opioid use disorder treatments prior to fatal overdoses and comparison to no treatment in Connecticut, 2016–17. Drug And Alcohol Dependence 2023, 254: 111040. PMID: 38043226, PMCID: PMC10872282, DOI: 10.1016/j.drugalcdep.2023.111040.Peer-Reviewed Original ResearchConceptsNon-medication treatmentsRelative riskOpioid overdose deathsIncidence rateMOUD treatmentOverdose deathsOpioid use disorder treatmentResults Incidence ratesRetrospective cohort studyDifferent treatment modalitiesPopulation-level effortsUse disorder treatmentFatal opioid poisoningsCohort studyOpioid poisoningTreatment modalitiesConclusion ExposurePoisoning deathsFatal overdosesTreatment exposureDisorder treatmentDeathTreatmentMethadoneRiskLeveraging a Learning Collaborative Model to Develop and Pilot Quality Measures to Improve Opioid Prescribing in the Emergency Department
Hawk K, Weiner S, Rothenberg C, Bernstein E, D'Onofrio G, Herring A, Hoppe J, Ketcham E, LaPietra A, Nelson L, Perrone J, Ranney M, Samuels E, Strayer R, Sharma D, Goyal P, Schuur J, Venkatesh A. Leveraging a Learning Collaborative Model to Develop and Pilot Quality Measures to Improve Opioid Prescribing in the Emergency Department. Annals Of Emergency Medicine 2023, 83: 225-234. PMID: 37831040, DOI: 10.1016/j.annemergmed.2023.08.490.Peer-Reviewed Original ResearchAtraumatic back painCommunity EDED visitsBack painOpioid prescribing practicesFirst-line treatmentEmergency department patientsOpioid use disorderQuality improvement projectEvidence-based resourcesOpioid administrationOpioid prescriptionsDental painSafe analgesiaDepartment patientsOpioid pillsPrescribing practicesEmergency departmentAmerican CollegeUse disordersMedication safety educationPainOpioidsImprovement projectVisitsComputational phenotypes for patients with opioid-related disorders presenting to the emergency department
Taylor R, Gilson A, Schulz W, Lopez K, Young P, Pandya S, Coppi A, Chartash D, Fiellin D, D’Onofrio G. Computational phenotypes for patients with opioid-related disorders presenting to the emergency department. PLOS ONE 2023, 18: e0291572. PMID: 37713393, PMCID: PMC10503758, DOI: 10.1371/journal.pone.0291572.Peer-Reviewed Original ResearchConceptsSubstance use disordersUse disordersED visitsPatient presentationCarlson comorbidity indexOpioid-related diagnosesOpioid-related disordersOne-year survivalRate of medicationOpioid use disorderElectronic health record dataPatient-oriented outcomesYears of ageHealth record dataChronic substance use disordersED returnComorbidity indexAcute overdoseMedical managementClinical entityRetrospective studyEmergency departmentChronic conditionsInclusion criteriaUnique cohortEarly emergency department experience with 7‐day extended‐release injectable buprenorphine for opioid use disorder
D'Onofrio G, Perrone J, Hawk K, Cowan E, McCormack R, Coupet E, Owens P, Martel S, Huntley K, Walsh S, Lofwall M, Herring A, Investigators T. Early emergency department experience with 7‐day extended‐release injectable buprenorphine for opioid use disorder. Academic Emergency Medicine 2023, 30: 1264-1271. PMID: 37501652, PMCID: PMC10822018, DOI: 10.1111/acem.14782.Peer-Reviewed Original ResearchConceptsOpioid use disorderEmergency departmentUse disordersSevere opioid use disorderOngoing clinical trialsEuropean Medicines AgencyEmergency department experienceInjectable buprenorphineClinician barriersED patientsED settingEmergency cliniciansInsurance statusClinical trialsReferral sitesDrug AdministrationMedicines AgencyBuprenorphine preparationsMedicationsU.S. FoodTreatment innovationsBuprenorphineDepartment's experienceEarly experienceDisordersImpact of Marital Stress on 1‐Year Health Outcomes Among Young Adults With Acute Myocardial Infarction
Zhu C, Dreyer R, Li F, Spatz E, Caraballo‐Cordovez C, Mahajan S, Raparelli V, Leifheit E, Lu Y, Krumholz H, Spertus J, D'Onofrio G, Pilote L, Lichtman J. Impact of Marital Stress on 1‐Year Health Outcomes Among Young Adults With Acute Myocardial Infarction. Journal Of The American Heart Association 2023, 12: e030031. PMID: 37589125, PMCID: PMC10547344, DOI: 10.1161/jaha.123.030031.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionCardiac-specific qualityGeneric health statusMyocardial infarctionBaseline healthMarital stressHealth outcomesHealth statusWorse patient-reported outcomesMental healthYoung adultsObservational cohort studyPatient-reported outcomesSocioeconomic factorsWorse mental healthReadmission 1Cause readmissionCohort studyYounger patientsRoutine screeningDepressive symptomsGreater oddsAnginaMale participantsOutcomesYale Emergency Scholars (YES) Program: A model for expanding emergency medicine research capacity
Yang D, Panthagani K, Ryus C, Nelson A, Wright D, Sherak R, Bernstein S, D'Onofrio G. Yale Emergency Scholars (YES) Program: A model for expanding emergency medicine research capacity. Academic Emergency Medicine 2023, 30: 1179-1182. PMID: 37436420, DOI: 10.1111/acem.14777.Peer-Reviewed Original ResearchFentanyl-Associated Overdose Deaths Outside the Hospital
Jeffery M, Stevens M, D'Onofrio G, Melnick E. Fentanyl-Associated Overdose Deaths Outside the Hospital. New England Journal Of Medicine 2023, 389: 87-88. PMID: 37342960, PMCID: PMC10388669, DOI: 10.1056/nejmc2304991.Peer-Reviewed Original ResearchURINE TOXICOLOGY PROFILES OF EMERGENCY DEPARTMENT PATIENTS WITH UNTREATED OPIOID USE DISORDER: A MULTI-SITE VIEW
Cowan E, Perrone J, Dziura J, Edelman E, Hawk K, Herring A, McCormack R, Murphy A, Phadke M, Fiellin D, D'Onofrio G. URINE TOXICOLOGY PROFILES OF EMERGENCY DEPARTMENT PATIENTS WITH UNTREATED OPIOID USE DISORDER: A MULTI-SITE VIEW. Journal Of Emergency Medicine 2023, 65: e357-e365. PMID: 37716904, PMCID: PMC10591927, DOI: 10.1016/j.jemermed.2023.06.007.Peer-Reviewed Original ResearchUrine drug screensOpioid use disorderEmergency departmentUntreated opioid use disorderAdult ED patientsOpioid overdose deathsED patientsOnly opioidCommon opioidsOverdose deathsUse disordersCommon drugsOpioidsPolysubstance useDrug useDrug screensAmphetamine-type stimulantsFentanylPatientsAddiction treatmentStimulantsParticipantsBuprenorphineMethadoneBenzodiazepinesNational Institute on Drug Abuse Clinical Trials Network Meeting Report: Advancing Emergency Department Initiation of Buprenorphine for Opioid Use Disorder
Cowan E, Perrone J, Bernstein S, Coupet E, Fiellin D, Hawk K, Herring A, Huntley K, McCormack R, Venkatesh A, D'Onofrio G. National Institute on Drug Abuse Clinical Trials Network Meeting Report: Advancing Emergency Department Initiation of Buprenorphine for Opioid Use Disorder. Annals Of Emergency Medicine 2023, 82: 326-335. PMID: 37178101, PMCID: PMC10524880, DOI: 10.1016/j.annemergmed.2023.03.025.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsOpioid use disorderEmergency departmentUse disordersDrug Abuse Clinical Trials NetworkEffective evidence-based treatmentsEmergency department initiationStandard emergency careMajor public health crisisClinical Trials NetworkEvidence of efficacyNational InstituteEvidence-based treatmentsOpioid overdose deathsTechnology-based interventionsBuprenorphine dosingBuprenorphine initiationPeer-based interventionsPublic health crisisPatient outcomesED staffOverdose deathsEmergency careBuprenorphineTrials NetworkUniversal uptakePerspectives on and experiences of emergency department–initiated buprenorphine among clinical pharmacists: A multi-site qualitative study
Justen M, Edelman E, Chawarski M, Coupet E, Cowan E, Lyons M, Owens P, Martel S, Richardson L, Rothman R, Whiteside L, O'Connor P, Zahn E, D'Onofrio G, Fiellin D, Hawk K. Perspectives on and experiences of emergency department–initiated buprenorphine among clinical pharmacists: A multi-site qualitative study. Journal Of Substance Use And Addiction Treatment 2023, 155: 209058. PMID: 37149149, DOI: 10.1016/j.josat.2023.209058.Peer-Reviewed Original ResearchConceptsOpioid use disorderClinical pharmacistsED careEmergency department-initiated buprenorphineEffective OUD treatmentEffectiveness-implementation studyHealth Services frameworkFocus groups/interviewsMulti-site qualitative studyFuture implementation effortsOUD treatmentUrban EDGroups/interviewsEmergency departmentPromoting ActionUnique pharmacologyED staffBuprenorphinePharmacist participantsUse disordersED contextPharmacistsPractice changePharmacy resourcesSuccessful program implementationImplementing Programs to Initiate Buprenorphine for Opioid Use Disorder Treatment in High-Need, Low-Resource Emergency Departments: A Nonrandomized Controlled Trial
McCormack R, Rotrosen J, Gauthier P, D'Onofrio G, Fiellin D, Marsch L, Novo P, Liu D, Edelman E, Farkas S, Matthews A, Mulatya C, Salazar D, Wolff J, Knight R, Goodman W, Williams J, Hawk K. Implementing Programs to Initiate Buprenorphine for Opioid Use Disorder Treatment in High-Need, Low-Resource Emergency Departments: A Nonrandomized Controlled Trial. Annals Of Emergency Medicine 2023, 82: 272-287. PMID: 37140493, PMCID: PMC10524047, DOI: 10.1016/j.annemergmed.2023.02.013.Peer-Reviewed Original ResearchConceptsBuprenorphine programImplementation facilitationEmergency departmentMedical recordsOpioid use disorder treatmentMain secondary outcomesMore treatment visitsPrimary implementation outcomeNonrandomized Controlled TrialPatient-level outcomesPatients' medical recordsUse disorder treatmentTreatment 30 daysBuprenorphine administrationOpioid useSecondary outcomesControlled TrialsTreatment visitsED settingUnique patientsClinicians' readinessEligibility criteriaClinical protocolsDisorder treatmentOverdose eventsUse of an Automated Bilingual Digital Health Tool to Reduce Unhealthy Alcohol Use Among Latino Emergency Department Patients
Vaca F, Dziura J, Abujarad F, Pantalon M, Hsiao A, Reynolds J, Maciejewski K, Field C, D’Onofrio G. Use of an Automated Bilingual Digital Health Tool to Reduce Unhealthy Alcohol Use Among Latino Emergency Department Patients. JAMA Network Open 2023, 6: e2314848. PMID: 37219901, PMCID: PMC10208138, DOI: 10.1001/jamanetworkopen.2023.14848.Peer-Reviewed Original ResearchConceptsStandard care groupNumber of bingesEmergency department patientsStandard careED patientsCare groupBrief interventionDepartment patientsAlcohol screeningDisease burdenUnhealthy drinkingDigital health toolsLevel II trauma centerHealth toolsParticipants 25 yearsAlcohol-related health disparitiesTertiary care centerAdverse health behaviorsUnhealthy alcohol useHigh disease burdenAlcohol use disorderTimeline followback methodEmergency medical careSelf-reported numberHigh-risk drinking