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 patients
2021
High-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 patientsA Brief Negotiation Interview Adherence Scale for Smoking Cessation: A psychometric evaluation
Pantalon MV, Dziura J, Li FY, D'Onofrio G, Weiss J, Bernstein SL. A Brief Negotiation Interview Adherence Scale for Smoking Cessation: A psychometric evaluation. Journal Of Substance Use And Addiction Treatment 2021, 126: 108398. PMID: 34116807, DOI: 10.1016/j.jsat.2021.108398.Peer-Reviewed Original ResearchConceptsBrief Negotiation InterviewNicotine replacement therapySmoking cessationAdherence ScaleQuitline referralHigh-risk alcohol consumptionOpioid use disorderPsychometric propertiesReplacement therapyEmergency departmentExcellent internal consistencyTobacco abstinenceClinical trialsInter-rater reliabilityUse disordersAlcohol consumptionPsychometric evaluationCessationFactor 1Behavioral contractingDiscriminant validityFactor 2Independent ratersPredictive validityInternal consistencyA SMARTTT approach to Treating Tobacco use disorder in persons with HIV (SMARTTT): Rationale and design for a hybrid type 1 effectiveness-implementation study
Edelman EJ, Dziura J, Deng Y, Bold KW, Murphy SM, Porter E, Sigel KM, Yager JE, Ledgerwood DM, Bernstein SL. A SMARTTT approach to Treating Tobacco use disorder in persons with HIV (SMARTTT): Rationale and design for a hybrid type 1 effectiveness-implementation study. Contemporary Clinical Trials 2021, 110: 106379. PMID: 33794354, PMCID: PMC8478961, DOI: 10.1016/j.cct.2021.106379.Peer-Reviewed Original ResearchConceptsTobacco use disorderNicotine replacement therapyUse disordersHIV clinicHybrid type 1 effectiveness-implementation designHIV viral load suppressionCD4 cell countViral load suppressionEffectiveness-implementation studyOptimal treatment approachPharmacist-delivered interventionSequential multiple assignmentHealth of personsImplementation science frameworkSecondary outcomesAntiretroviral treatmentPrimary outcomeClinical pharmacistsReplacement therapySmoking abstinenceTreatment approachesCell countHealth systemHIVContingency managementThe design and conduct of a randomized clinical trial comparing emergency department initiation of sublingual versus a 7-day extended-release injection formulation of buprenorphine for opioid use disorder: Project ED Innovation
D'Onofrio G, Hawk KF, Herring AA, Perrone J, Cowan E, McCormack RP, Dziura J, Taylor RA, Coupet E, Edelman EJ, Pantalon MV, Owens PH, Martel SH, O'Connor PG, Van Veldhuisen P, DeVogel N, Huntley K, Murphy SM, Lofwall MR, Walsh SL, Fiellin DA. The design and conduct of a randomized clinical trial comparing emergency department initiation of sublingual versus a 7-day extended-release injection formulation of buprenorphine for opioid use disorder: Project ED Innovation. Contemporary Clinical Trials 2021, 104: 106359. PMID: 33737199, PMCID: PMC9153252, DOI: 10.1016/j.cct.2021.106359.Peer-Reviewed Original ResearchConceptsOpioid use disorderRandomized clinical trialsPrimary outcomeFormal addiction treatmentOpioid withdrawalClinical trialsAncillary studiesUse disordersSelf-reported opioid useAddiction treatmentEmergency department initiationIncremental cost-effectiveness ratioReceipt of medicationEmergency department studyHealth service utilizationCost-effectiveness ratioOpioid useSecondary outcomesService utilizationTreatment accessEligibility criteriaImplementation facilitationBuprenorphineOverdose eventsDepartment study
2020
Validating 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 regressionPatientsTrial 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, 97: 106128. PMID: 32950400, PMCID: PMC7721867, DOI: 10.1016/j.cct.2020.106128.Peer-Reviewed Original ResearchAlcohol 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/schoolTrial 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 patientsProgress Report on EMBED: A Pragmatic Trial of User-Centered Clinical Decision Support to Implement EMergency Department-Initiated BuprenorphinE for Opioid Use Disorder †
Melnick ER, Nath B, Ahmed OM, Brandt C, Chartash D, Dziura JD, Hess EP, Holland WC, Hoppe JA, Jeffery MM, Katsovich L, Li F, Lu CC, Maciejewski K, Maleska M, Mao JA, Martel S, Michael S, Paek H, Patel MD, Platts-Mills TF, Rajeevan H, Ray JM, Skains RM, Soares WE, Deutsch A, Solad Y, D’Onofrio G. Progress Report on EMBED: A Pragmatic Trial of User-Centered Clinical Decision Support to Implement EMergency Department-Initiated BuprenorphinE for Opioid Use Disorder †. Journal Of Psychiatry And Brain Science 2020, 2: e200003. PMID: 32309637, PMCID: PMC7164817, DOI: 10.20900/jpbs.20200003.Peer-Reviewed Original ResearchBuprenorphine/naloxoneOpioid use disorderClinical decision supportPragmatic trialElectronic health recordsUse disordersEmergency Department-Initiated BuprenorphineMulti-centre pragmatic trialRoutine emergency careHealthcare systemRates of EDNaloxone prescribingPilot testingSingle EDEmergency departmentPhysicians' perceptionsEmergency careMortality rateEarly identificationComputable phenotypeUnique physiciansInformed consentCare paradigmHealth recordsIntervention effectiveness
2019
User-centred clinical decision support to implement emergency department-initiated buprenorphine for opioid use disorder: protocol for the pragmatic group randomised EMBED trial
Melnick ER, Jeffery MM, Dziura JD, Mao JA, Hess EP, Platts-Mills TF, Solad Y, Paek H, Martel S, Patel MD, Bankowski L, Lu C, Brandt C, D’Onofrio G. User-centred clinical decision support to implement emergency department-initiated buprenorphine for opioid use disorder: protocol for the pragmatic group randomised EMBED trial. BMJ Open 2019, 9: e028488. PMID: 31152039, PMCID: PMC6550013, DOI: 10.1136/bmjopen-2018-028488.Peer-Reviewed Original ResearchMeSH KeywordsAdultBuprenorphineCluster AnalysisDecision Support Systems, ClinicalEmergency Service, HospitalFemaleHumansMaleMiddle AgedMulticenter Studies as TopicNarcotic AntagonistsOpiate Substitution TreatmentOpioid-Related DisordersPragmatic Clinical Trials as TopicRandomized Controlled Trials as TopicUnited StatesYoung AdultConceptsOpioid use disorderEmergency departmentSecondary outcomesUse disordersEmergency department-initiated buprenorphineWestern Institutional Review BoardData Safety Monitoring BoardIndependent study monitorsRates of cliniciansRoutine emergency careSafety monitoring boardInstitutional review boardClinical decision support systemClinician prescribingPragmatic clusterPatient characteristicsPeer-reviewed journalsClinical decision supportPrimary outcomeED cliniciansWithdrawal symptomsOngoing treatmentPatients' willingnessMonitoring boardBuprenorphineIntegrated stepped alcohol treatment for patients with HIV and alcohol use disorder: a randomised controlled 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 alcohol use disorder: a randomised controlled trial. The Lancet HIV 2019, 6: e509-e517. PMID: 31109915, PMCID: PMC7161741, DOI: 10.1016/s2352-3018(19)30076-1.Peer-Reviewed Original ResearchConceptsAlcohol use disorderWeek 24Use disordersAlcohol treatmentAdverse eventsNumber of drinksTreatment medicationsPhysician managementAlcohol abuseMental Disorders-IV criteriaAlcohol-related careFormal alcohol treatmentKey exclusion criteriaTimeline followback methodMotivational enhancement therapyTreat populationHIV clinicHIV outcomesPrimary outcomeSpecialty referralsMean ageUS National InstitutesWeek 4Medical conditionsExclusion criteria
2017
An Interventionist Adherence Scale for a Specialized Brief Negotiation Interview Focused on Treatment Engagement for Opioid use Disorders
Pantalon MV, Dziura J, Li FY, Owens PH, O'Connor PG, D'Onofrio G. An Interventionist Adherence Scale for a Specialized Brief Negotiation Interview Focused on Treatment Engagement for Opioid use Disorders. Substance Use & Addiction Journal 2017, 38: 191-199. PMID: 28398192, PMCID: PMC7222694, DOI: 10.1080/08897077.2017.1294548.Peer-Reviewed Original ResearchConceptsTreatment engagementPsychometric propertiesUse disordersPredictive validityBrief Negotiation InterviewGood internal consistencyEnhance motivationBrief interventionDiscriminant validityFair predictive validitySkill performanceValid measureInternal consistencyExcellent interrater reliabilityControl encountersBASFactor itemsMotivationEngagementDisordersCritical actionsOpioid use disorderValidityRatersItems
2015
Trends in Any and High-Dose Opioid Analgesic Receipt Among Aging Patients With and Without HIV
Becker WC, Gordon K, Jennifer Edelman E, Kerns RD, Crystal S, Dziura JD, Fiellin LE, Gordon AJ, Goulet JL, Justice AC, Fiellin DA. Trends in Any and High-Dose Opioid Analgesic Receipt Among Aging Patients With and Without HIV. AIDS And Behavior 2015, 20: 679-686. PMID: 26384973, PMCID: PMC5006945, DOI: 10.1007/s10461-015-1197-5.Peer-Reviewed Original Research