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 patients
2023
Implementing 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 drinkingImplementation 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 OUTCOMEAssociation of Sociodemographic Characteristics With 1-Year Hospital Readmission Among Adults Aged 18 to 55 Years With Acute Myocardial Infarction
Okafor C, Zhu C, Raparelli V, Murphy T, Arakaki A, D’Onofrio G, Tsang S, Smith M, Lichtman J, Spertus J, Pilote L, Dreyer R. Association of Sociodemographic Characteristics With 1-Year Hospital Readmission Among Adults Aged 18 to 55 Years With Acute Myocardial Infarction. JAMA Network Open 2023, 6: e2255843. PMID: 36787140, PMCID: PMC9929697, DOI: 10.1001/jamanetworkopen.2022.55843.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionYoung adultsHospital readmissionBlack raceMyocardial infarctionRacial differencesCardiac factorsSociodemographic characteristicsBlack individualsOdds of readmissionObservational cohort studyMedical record abstractionRisk of readmissionWhite individualsAdults Aged 18Year of dischargePostdischarge readmissionVIRGO StudyCause readmissionCohort studyPrimary outcomeRecord abstractionMulticenter studyAged 18Male ratio
2022
Missed 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 patientsAssociation of State Social and Environmental Factors With Rates of Self-injury Mortality and Suicide in the United States
Rockett IRH, Jia H, Ali B, Banerjee A, Connery HS, Nolte KB, Miller T, White FMM, DiGregorio BD, Larkin GL, Stack S, Kõlves K, McHugh RK, Lulla VO, Cossman J, De Leo D, Hendricks B, Nestadt PS, Berry JH, D’Onofrio G, Caine ED. Association of State Social and Environmental Factors With Rates of Self-injury Mortality and Suicide in the United States. JAMA Network Open 2022, 5: e2146591. PMID: 35138401, PMCID: PMC8829661, DOI: 10.1001/jamanetworkopen.2021.46591.Peer-Reviewed Original ResearchConceptsSelf-injury mortalityMAIN OUTCOMEOverdose fatalitiesNon-Hispanic white raceDrug intoxication deathsLeast absolute shrinkageRate ratioCross-sectional studyHealth care accessPublic health policySelf-harm behaviorsAbsolute shrinkageIntoxication deathsWhite raceCare accessInjury mechanismMedical examiner systemEtiologic understandingDeath dataDisease controlUnderlying causeHealth policyDeath investigation processDemographic characteristicsDistrict of ColumbiaPerspectives 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
2021
Feasibility and acceptability of electronic administration of patient reported outcomes using mHealth platform in emergency department patients with non-medical opioid use
Hawk K, Malicki C, Kinsman J, D’Onofrio G, Taylor A, Venkatesh A. Feasibility and acceptability of electronic administration of patient reported outcomes using mHealth platform in emergency department patients with non-medical opioid use. Addiction Science & Clinical Practice 2021, 16: 66. PMID: 34758881, PMCID: PMC8579535, DOI: 10.1186/s13722-021-00276-0.Peer-Reviewed Original ResearchConceptsNon-medical opioid useOpioid use disorderOpioid useEmergency departmentED patientsED visitsPrescription medicationsMHealth platformUrban academic emergency departmentEligible adult patientsEmergency department patientsPathways of careTransitions of careAcademic emergency departmentAbsence of patientsElectronic surveyCollection of PROsMeasures of feasibilityOverdose risk behaviorsHalf of participantsMobile health platformNear-term outcomesElectronic health recordsAdult patientsHospital dischargeVariations 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 OUTCOMESDOHHospitalImpact of Race on the In‐Hospital Quality of Care Among Young Adults With Acute Myocardial Infarction
Raparelli V, Benea D, Smith M, Behlouli H, Murphy TE, D’Onofrio G, Pilote L, Dreyer RP. Impact of Race on the In‐Hospital Quality of Care Among Young Adults With Acute Myocardial Infarction. Journal Of The American Heart Association 2021, 10: e021408. PMID: 34431311, PMCID: PMC8649291, DOI: 10.1161/jaha.121.021408.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionCardiac readmissionMyocardial infarctionHospital qualitySocial determinantsYoung adultsWhite individualsBlack individualsSegment elevation myocardial infarctionCardiac risk factorsMultivariable logistic regressionHigh rateWhite US adultsVIRGO StudyBlack raceAMI careRisk factorsCare scoresHigh prevalenceUS adultsReadmissionLogistic regressionInfarctionImpact of raceRacial disparitiesImplementation of Oral and Extended-Release Naltrexone for the Treatment of Emergency Department Patients With Moderate to Severe Alcohol Use Disorder: Feasibility and Initial Outcomes
Anderson ES, Chamberlin M, Zuluaga M, Ullal M, Hawk K, McCormack R, D'Onofrio G, Herring AA. Implementation of Oral and Extended-Release Naltrexone for the Treatment of Emergency Department Patients With Moderate to Severe Alcohol Use Disorder: Feasibility and Initial Outcomes. Annals Of Emergency Medicine 2021, 78: 752-758. PMID: 34353648, DOI: 10.1016/j.annemergmed.2021.05.013.Peer-Reviewed Original ResearchConceptsAlcohol use disorderSevere alcohol use disorderFormal addiction treatmentIntramuscular naltrexoneOral naltrexoneUse disordersAddiction treatmentED patientsExtended-release naltrexoneEffectiveness of naltrexoneEmergency department patientsED dischargeAdult patientsDepartment patientsNaltrexone treatmentEmergency departmentMean ageEffective treatmentNaltrexonePatientsClinical protocolsBrief interventionDescriptive studyDisordersInitial outcomesHigh-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 patientsEmergency Department Visits for Nonfatal Opioid Overdose During the COVID-19 Pandemic Across Six US Health Care Systems
Soares WE, Melnick ER, Nath B, D'Onofrio G, Paek H, Skains RM, Walter LA, Casey MF, Napoli A, Hoppe JA, Jeffery MM. Emergency Department Visits for Nonfatal Opioid Overdose During the COVID-19 Pandemic Across Six US Health Care Systems. Annals Of Emergency Medicine 2021, 79: 158-167. PMID: 34119326, PMCID: PMC8449788, DOI: 10.1016/j.annemergmed.2021.03.013.Peer-Reviewed Original ResearchConceptsHealth care systemCause ED visitsNonfatal opioid overdoseED visitsOpioid use disorderCare systemOpioid overdoseUse disordersCOVID-19 pandemicOpioid-related complicationsEmergency department visitsHospital-based interventionsED visit ratesEmergency department utilizationVisit countsUS health care systemOpioid overdose ratesDepartment visitsHistorical controlsAdult visitsOpioid overdosesOverdose ratesMedical emergencyVisit ratesMore weeksA qualitative study of emergency department patients who survived an opioid overdose: Perspectives on treatment and unmet needs
Hawk K, Grau LE, Fiellin DA, Chawarski M, O’Connor P, Cirillo N, Breen C, D’Onofrio G. A qualitative study of emergency department patients who survived an opioid overdose: Perspectives on treatment and unmet needs. Academic Emergency Medicine 2021, 28: 542-552. PMID: 33346926, PMCID: PMC8281441, DOI: 10.1111/acem.14197.Peer-Reviewed Original ResearchConceptsOpioid use disorderEmergency departmentSubstance use treatmentOpioid overdosePatient's perspectiveUnmet needUse treatmentAcute opioid overdoseAdult ED patientsEmergency department patientsPatient support servicesProvider communication skillsEmergency medicine cliniciansAcademic emergency departmentSocial ecologic modelEvidence-based treatmentsChoice of patientsBrief quantitative surveyPatient-oriented approachOpioid useDepartment patientsOUD treatmentUnmet basic needsED careED patients
2020
Emergency department patients with untreated opioid use disorder: A comparison of those seeking versus not seeking referral to substance use treatment
Coupet E, D’Onofrio G, Chawarski M, Edelman E, O’Connor P, Owens P, Martel S, Fiellin DA, Cowan E, Richardson L, Huntley K, Whiteside LK, Lyons MS, Rothman RE, Pantalon M, Hawk K. Emergency department patients with untreated opioid use disorder: A comparison of those seeking versus not seeking referral to substance use treatment. Drug And Alcohol Dependence 2020, 219: 108428. PMID: 33307301, PMCID: PMC8110210, DOI: 10.1016/j.drugalcdep.2020.108428.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderEmergency department patientsDepartment patientsUse disordersTenth Revision diagnosis codesSevere opioid use disorderConclusions Most patientsInjection-related infectionsRevision diagnosis codesHealth insurance statusSubstance use treatmentCross-sectional analysisOpioid withdrawalClinical characteristicsED visitsMost patientsTreatment initiationUrine toxicologyClinical correlatesDiagnosis codesInsurance statusUnivariate analysisBackground LittleInternational ClassificationTrends in the Use of Buprenorphine in US Emergency Departments, 2002-2017
Rhee TG, D’Onofrio G, Fiellin DA. Trends in the Use of Buprenorphine in US Emergency Departments, 2002-2017. JAMA Network Open 2020, 3: e2021209. PMID: 33079195, PMCID: PMC7576404, DOI: 10.1001/jamanetworkopen.2020.21209.Peer-Reviewed Original ResearchTrends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US
Jeffery MM, D’Onofrio G, Paek H, Platts-Mills TF, Soares WE, Hoppe JA, Genes N, Nath B, Melnick ER. Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US. JAMA Internal Medicine 2020, 180: 1328-1333. PMID: 32744612, PMCID: PMC7400214, DOI: 10.1001/jamainternmed.2020.3288.Peer-Reviewed Original ResearchConceptsHospital admission ratesEmergency department visitsED visitsHealth care systemAdmission ratesDepartment visitsHospital admissionCare systemCOVID-19 pandemicLarge health care systemAcute care deliveryCross-sectional studyAnnual ED volumeCoronavirus disease 2019Daily ED visitsInflux of patientsPublic health officialsCOVID-19 case ratesCOVID-19 casesNational public healthDisease 2019MAIN OUTCOMEED volumeSerious symptomsContagious infectionBarriers and Facilitators to Clinician Readiness to Provide Emergency Department–Initiated Buprenorphine
Hawk KF, D’Onofrio G, Chawarski MC, O’Connor P, Cowan E, Lyons MS, Richardson L, Rothman RE, Whiteside LK, Owens PH, Martel SH, Coupet E, Pantalon M, Curry L, Fiellin DA, Edelman EJ. Barriers and Facilitators to Clinician Readiness to Provide Emergency Department–Initiated Buprenorphine. JAMA Network Open 2020, 3: e204561. PMID: 32391893, PMCID: PMC7215257, DOI: 10.1001/jamanetworkopen.2020.4561.Peer-Reviewed Original ResearchConceptsOpioid use disorderEmergency departmentAdvanced practice cliniciansED cliniciansClinicians' readinessOngoing treatmentTreatment of OUDEmergency Department-Initiated BuprenorphineUntreated opioid use disorderDrug Addiction Treatment ActDecrease opioid useVisual analog scaleHealth Services frameworkAcademic emergency departmentMixed-methods formative evaluationQuality of careSubset of participantsBuprenorphine initiationClinician typeOpioid useED patientsAnalog scaleOngoing careDepartmental protocolPractice clinicians