2023
Real-World Observational Evaluation of Common Interventions to Reduce Emergency Department Prescribing of Opioid Medications
Sangal R, Rothenberg C, Hawk K, D'Onofrio G, Hsiao A, Solad Y, Venkatesh A. Real-World Observational Evaluation of Common Interventions to Reduce Emergency Department Prescribing of Opioid Medications. The Joint Commission Journal On Quality And Patient Safety 2023, 49: 239-246. PMID: 36914528, DOI: 10.1016/j.jcjq.2023.01.013.Peer-Reviewed Original ResearchConceptsOpioid prescribingED visitsElectronic health recordsOpioid prescriptionsEmergency department opioid prescriptionsAnalgesia prescriptionOpioid stewardshipOpioid medicationsSecondary outcomesPrimary outcomePreintervention periodInterruptive alertsCommon interventionPrescribingAlert fatigueElectronic prescribingPrevious interventionsHospital systemObservational evaluationHealth recordsVisitsStewardship policiesInterventionOutcomesPrescription
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 elementsUser 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 patientsClinical Profile and Sex-Specific Recovery With Cardiac Rehabilitation After Coronary Artery Bypass Grafting Surgery
Safdar B, Mori M, Nowroozpoor A, Geirsson A, D'Onofrio G, Mangi AA. Clinical Profile and Sex-Specific Recovery With Cardiac Rehabilitation After Coronary Artery Bypass Grafting Surgery. Clinical Therapeutics 2022, 44: 846-858. PMID: 35570056, DOI: 10.1016/j.clinthera.2022.04.002.Peer-Reviewed Original ResearchConceptsCardiac rehabilitationElectronic health recordsComposite outcomeEndothelial functionClinical profileCoronary Artery Bypass Grafting SurgeryMajor adverse cardiac outcomesPostoperative blood transfusionTwelve-month mortalityCardiac risk factorsCoronary artery bypassPrimary composite outcomeRetrospective cohort studyHealth recordsAdverse cardiac outcomesCardiac risk profileKaplan-Meier analysisBody mass indexSex-specific outcomesKaplan-Meier plotsThoracic Surgeons registryAerobic exercise durationHigher hemoglobin AHealth care systemUrgent CABG
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 dischargeHigh-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 patients
2020
Progress 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
An integrated web application for decision support and automation of EHR workflow: a case study of current challenges to standards-based messaging and scalability from the EMBED trial
Melnick ER, Holland WC, Ahmed OM, K A, Michael SS, Goldberg HS, Lagier C, D’Onofrio G, Stachowiak T, Brandt C, Solad Y. An integrated web application for decision support and automation of EHR workflow: a case study of current challenges to standards-based messaging and scalability from the EMBED trial. JAMIA Open 2019, 2: 434-439. PMID: 32025639, PMCID: PMC6994013, DOI: 10.1093/jamiaopen/ooz053.Peer-Reviewed Original ResearchComputerized clinical decision supportWeb applicationCDS developmentDecision supportIntegrated web applicationWeb-based solutionTwo-way messagingClinical decision supportElectronic health recordsSecurity concernsData standardsRobust sharingEHR workflowScalabilityHealth recordsInteroperabilityLocal customizationRapid integrationFuture standardsMessagingImplementationCD interventionChallengesAutomationCase study