2024
Cost-Effectiveness of Implementation Facilitation to Promote Emergency Department-Initiated Buprenorphine for Opioid Use Disorder
Lu T, Ryan D, Cadet T, Chawarski M, Coupet E, Edelman E, Hawk K, Huntley K, Jalali A, O'Connor P, Owens P, Martel S, Fiellin D, D'Onofrio G, Murphy S. Cost-Effectiveness of Implementation Facilitation to Promote Emergency Department-Initiated Buprenorphine for Opioid Use Disorder. Annals Of Emergency Medicine 2024 PMID: 39570250, DOI: 10.1016/j.annemergmed.2024.10.001.Peer-Reviewed Original ResearchHealth care sector perspectiveImplementation facilitatorsOpioid use disorder careIncremental cost-effectiveness ratioCost-effectiveness ratioHealth care sector costsEducational strategiesImplementation facilitation strategyCost-effectiveness acceptability curvesLikelihood of cost-effectivenessCost-effectiveOpioid use disorderQuality-adjusted life yearsUse disorderPatient engagementAcademic EDED visitsAcceptability curvesStandard educationEmergency departmentLife yearsFacilitation strategiesMeasures of effectivenessHealthBuprenorphine403EMF Barriers and Facilitators to Addiction Treatment Access From the Emergency Department Among Black Individuals With Opioid Use Disorder
Coupet E, Chawarski M, Hercules K, Williams J, Murphy A, Owens P, D'Onofrio G. 403EMF Barriers and Facilitators to Addiction Treatment Access From the Emergency Department Among Black Individuals With Opioid Use Disorder. Annals Of Emergency Medicine 2024, 84: s182-s183. DOI: 10.1016/j.annemergmed.2024.08.403.Peer-Reviewed Original Research
2023
Leveraging 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 experienceDisordersURINE 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 eventsPerspectives of Clinicians and Staff at Community-Based Opioid Use Disorder Treatment Settings on Linkages With Emergency Department–Initiated Buprenorphine Programs
Sue K, Chawarski M, Curry L, McNeil R, Coupet E, Schwartz R, Wilder C, Tsui J, Hawk K, D’Onofrio G, O’Connor P, Fiellin D, Edelman E. Perspectives of Clinicians and Staff at Community-Based Opioid Use Disorder Treatment Settings on Linkages With Emergency Department–Initiated Buprenorphine Programs. JAMA Network Open 2023, 6: e2312718. PMID: 37163263, PMCID: PMC10173026, DOI: 10.1001/jamanetworkopen.2023.12718.Peer-Reviewed Original ResearchConceptsCommunity-based cliniciansOpioid use disorderEmergency departmentOUD treatmentMedication treatmentSubstance use disorders trainingUrban academic emergency departmentEffectiveness-implementation studyAcademic emergency departmentDisorder treatment settingsPerspectives of cliniciansCommunity-based treatmentCommunity-based treatment programsStaff perspectivesImplementation science frameworkBuprenorphine programTreatment cliniciansPeer navigatorsReferral sitesPromoting ActionMAIN OUTCOMEED staffBuprenorphineFocus groupsUse disordersImplementation Facilitation to Promote Emergency Department–Initiated Buprenorphine for Opioid Use Disorder
D’Onofrio G, Edelman E, Hawk K, Chawarski M, Pantalon M, Owens P, Martel S, Rothman R, Saheed M, Schwartz R, Cowan E, Richardson L, Salsitz E, Lyons M, Freiermuth C, Wilder C, Whiteside L, Tsui J, Klein J, Coupet E, O’Connor P, Matthews A, Murphy S, Huntley K, Fiellin D. Implementation Facilitation to Promote Emergency Department–Initiated Buprenorphine for Opioid Use Disorder. JAMA Network Open 2023, 6: e235439. PMID: 37017967, PMCID: PMC10077107, DOI: 10.1001/jamanetworkopen.2023.5439.Peer-Reviewed Original ResearchConceptsOpioid use disorderRate of patientsOUD treatmentImplementation facilitationED visitsObservational cohortED cliniciansX-waiverUse disordersEmergency Department-Initiated BuprenorphineUntreated opioid use disorderEvaluation periodHybrid type 3Provision of buprenorphineBaseline periodGrand roundsRates of EDPrimary outcomeWhite patientsAcademic EDBlack patientsED patientsEmergency departmentCommunity cliniciansMAIN OUTCOMEModeling human health behavior with a new index that measures connectivity
Bernstein S, Li F, Abujarad F, Grant D, D'Onofrio G, Dziura J. Modeling human health behavior with a new index that measures connectivity. Preventive Medicine Reports 2023, 33: 102172. PMID: 37223571, PMCID: PMC10201843, DOI: 10.1016/j.pmedr.2023.102172.Peer-Reviewed Original ResearchHealth behaviorsTrial of treatmentHospital emergency departmentUrban hospital emergency departmentAlcohol use disorderCritical health behaviorsEffects of interventionsPrimary endpointSubstance use interventionsMedication adherenceEmergency departmentOriginal trialBinge drinkingUse disordersHealthy behaviorsStudy designHuman health behaviourTrialsInterventionUse interventionsMonthly bingeAdherenceTreatmentDrinkingReal-time interventionsIncidence of Precipitated Withdrawal During a Multisite Emergency Department–Initiated Buprenorphine Clinical Trial in the Era of Fentanyl
D’Onofrio G, Hawk K, Perrone J, Walsh S, Lofwall M, Fiellin D, Herring A. Incidence of Precipitated Withdrawal During a Multisite Emergency Department–Initiated Buprenorphine Clinical Trial in the Era of Fentanyl. JAMA Network Open 2023, 6: e236108. PMID: 36995717, PMCID: PMC10064247, DOI: 10.1001/jamanetworkopen.2023.6108.Peer-Reviewed Original ResearchRacial and ethnic disparities in emergency department–initiated buprenorphine across five health care systems
Holland W, Li F, Nath B, Jeffery M, Stevens M, Melnick E, Dziura J, Khidir H, Skains R, D'Onofrio G, Soares W. Racial and ethnic disparities in emergency department–initiated buprenorphine across five health care systems. Academic Emergency Medicine 2023, 30: 709-720. PMID: 36660800, PMCID: PMC10467357, DOI: 10.1111/acem.14668.Peer-Reviewed Original ResearchConceptsOpioid use disorderCommunity emergency departmentsEmergency departmentDischarge diagnosisHealth care systemHispanic patientsBlack patientsHospital typeCare systemNon-Hispanic patientsOpioid overdose deathsClinical decision support systemOpioid withdrawalPrimary outcomeMedication treatmentBuprenorphine accessED treatmentTreatment accessOverdose deathsX-waiverBuprenorphinePatientsUse disordersEthnic disparitiesSecondary analysis
2022
Development and testing of data infrastructure in the American College of Emergency Physicians’ Clinical Emergency Data Registry for opioid‐related research
Taylor A, Kinsman J, Hawk K, D'Onofrio G, Malicki C, Malcom B, Goyal P, Venkatesh A. Development and testing of data infrastructure in the American College of Emergency Physicians’ Clinical Emergency Data Registry for opioid‐related research. Journal Of The American College Of Emergency Physicians Open 2022, 3: e12816. PMID: 36311336, PMCID: PMC9597093, DOI: 10.1002/emp2.12816.Peer-Reviewed Original ResearchElectronic health recordsEmergency departmentAmerican CollegeData registryEmergency care visitsOpioid use disorderStructured data collection toolNational clinical quality registryUrine drug testingClinical quality registryManual chart reviewValidity testingStandardized documentation templateOpioid medicationsCare visitsChart reviewEnvironmental scanPhysician reviewersMedicines RegistryModerate feasibilityQuality registryEmergency physiciansHospital careUse disordersCommon data elementsMissed Opportunities for HIV and Hepatitis C Screening Among Emergency Department Patients With Untreated Opioid Use Disorder
Lyons MS, Chawarski MC, Rothman R, Whiteside L, Cowan E, Richardson LD, Hawk K, Tsui JI, Schwartz RP, O’Connor P, D’Onofrio G, Fiellin DA, Edelman EJ. Missed Opportunities for HIV and Hepatitis C Screening Among Emergency Department Patients With Untreated Opioid Use Disorder. Journal Of Addiction Medicine 2022, 17: 210-214. PMID: 36170184, PMCID: PMC10023471, DOI: 10.1097/adm.0000000000001074.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderRecent injection drug useEmergency department HIVInjection drug useHCV screeningED patientsUse disordersEnrollment periodDrug useHepatitis C screeningStructured screening programmeUnknown HCV statusUnknown HIV statusHigh-risk cohortMedical care providersHCV statusC screeningHepatitis CED visitsAcademic EDHIV statusEmergency departmentCohort 2Cohort 1User 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 patientsUse of a Brief Negotiation Interview in the emergency department to reduce high‐risk alcohol use among older adults: A randomized trial
Shenvi CL, Wang Y, Revankar R, Phillips J, Bush M, Biese KJ, Aylward A, D'Onofrio G, Platts‐Mills T. Use of a Brief Negotiation Interview in the emergency department to reduce high‐risk alcohol use among older adults: A randomized trial. Journal Of The American College Of Emergency Physicians Open 2022, 3: e12651. PMID: 35156089, PMCID: PMC8828696, DOI: 10.1002/emp2.12651.Peer-Reviewed Original ResearchHigh-risk alcohol useBrief Negotiation InterviewEmergency departmentHigh-risk drinkersAlcohol usePrimary outcomeOlder adultsSingle academic emergency departmentAcademic emergency departmentNon-Hispanic whitesUsual careED visitsED patientsEligible individualsAlcohol abuseAlcohol consumptionFull criteriaAlcoholism definitionMonthsNational InstituteAdultsSignificant differencesPatientsSignificant reductionOutcomesEmergency department utilization for substance use disorders and mental health conditions during COVID-19
Venkatesh AK, Janke AT, Kinsman J, Rothenberg C, Goyal P, Malicki C, D’Onofrio G, Taylor A, Hawk K. Emergency department utilization for substance use disorders and mental health conditions during COVID-19. PLOS ONE 2022, 17: e0262136. PMID: 35025921, PMCID: PMC8757912, DOI: 10.1371/journal.pone.0262136.Peer-Reviewed Original ResearchConceptsOpioid use disorderOverall ED visitsED visitsEmergency departmentMental health conditionsAlcohol use disorderED visitationUse disordersED utilizationHospital-based emergency departmentsHealth conditionsEmergency department utilizationPublic health surveillance toolSite of careClinical quality registryEarly pandemic periodVisit countsSubstance use disordersCOVID-19COVID-19 pandemicED visit countsDiagnosis codesOutpatient treatmentMedicines RegistryQuality registryPerspectives About Emergency Department Care Encounters Among Adults With Opioid Use Disorder
Hawk K, McCormack R, Edelman EJ, Coupet E, Toledo N, Gauthier P, Rotrosen J, Chawarski M, Martel S, Owens P, Pantalon MV, O’Connor P, Whiteside LK, Cowan E, Richardson LD, Lyons MS, Rothman R, Marsch L, Fiellin DA, D’Onofrio G. Perspectives About Emergency Department Care Encounters Among Adults With Opioid Use Disorder. JAMA Network Open 2022, 5: e2144955. PMID: 35076700, PMCID: PMC8790663, DOI: 10.1001/jamanetworkopen.2021.44955.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderEmergency departmentED visitsOUD treatmentUse disordersPublic safety-net hospitalRural critical access hospitalsEmergency department careSafety-net hospitalUrban academic centerLife-saving treatmentCritical access hospitalsImplementation science frameworkPatient factorsTreatment initiationED careUS patientsStaff trainingDemand treatmentPatient readinessNet hospitalPatient's perspectivePromoting ActionImproved care