2023
Implementation 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 OUTCOME
2021
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
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
2019
Integrated 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
2016
Protocol for three parallel multi-site stepped care effectiveness studies for unhealthy alcohol use in HIV-positive patients
Edelman EJ, Maisto SA, Hansen NB, Cutter CJ, Dziura J, Fiellin LE, O'Connor PG, Bedimo R, Gibert C, Marconi VC, Rimland D, Rodriguez-Barradas MC, Simberkoff MS, Justice AC, Bryant KJ, Fiellin DA. Protocol for three parallel multi-site stepped care effectiveness studies for unhealthy alcohol use in HIV-positive patients. Contemporary Clinical Trials 2016, 52: 80-90. PMID: 27876616, PMCID: PMC5253227, DOI: 10.1016/j.cct.2016.11.008.Peer-Reviewed Original ResearchConceptsUnhealthy alcohol useAlcohol use disorderHIV-positive patientsMotivational enhancement therapyAlcohol useWeek 12Risk drinkingWeek 4Effective evidence-based treatmentsInfectious disease clinicHIV-positive individualsModerate alcohol useEvidence-based treatmentsParticipants meeting criteriaImplementation of interventionsVACS IndexHIV careSecondary outcomesCare trialsDisease clinicHIV morbidityPrimary outcomeAlcohol pharmacotherapyInitial treatmentLiver disease
2012
A Brief Intervention Reduces Hazardous and Harmful Drinking in Emergency Department Patients
D'Onofrio G, Fiellin DA, Pantalon MV, Chawarski MC, Owens PH, Degutis LC, Busch SH, Bernstein SL, O'Connor PG. A Brief Intervention Reduces Hazardous and Harmful Drinking in Emergency Department Patients. Annals Of Emergency Medicine 2012, 60: 181-192. PMID: 22459448, PMCID: PMC3811141, DOI: 10.1016/j.annemergmed.2012.02.006.Peer-Reviewed Original ResearchConceptsBrief Negotiation InterviewStandard careEmergency department patientsBrief interventionAlcohol consumptionDepartment patientsHarmful drinkersDrinking outcomesHarmful drinkingAssessment groupStandard care groupAdult ED patientsNegative health behaviorsSecondary outcomesPrimary outcomeED patientsCare groupED settingTelephone boosterBooster groupBinge episodesHealth behaviorsPatientsAlcohol useCare
2008
Long‐Term Treatment with Buprenorphine/Naloxone in Primary Care: Results at 2–5 Years
Fiellin DA, Moore BA, Sullivan LE, Becker WC, Pantalon MV, Chawarski MC, Barry DT, O'Connor PG, Schottenfeld RS. Long‐Term Treatment with Buprenorphine/Naloxone in Primary Care: Results at 2–5 Years. American Journal On Addictions 2008, 17: 116-120. PMID: 18393054, DOI: 10.1080/10550490701860971.Peer-Reviewed Original ResearchMeSH KeywordsAdultBuprenorphineCombined Modality TherapyCounselingCross-Sectional StudiesDose-Response Relationship, DrugDrug Administration ScheduleDrug Therapy, CombinationFemaleFollow-Up StudiesHeroin DependenceHumansLong-Term CareMaleMiddle AgedNaloxoneNarcotic AntagonistsOpioid-Related DisordersPatient DropoutsPrimary Health CareSubstance Abuse DetectionTreatment OutcomeConceptsOpioid-dependent patientsAdverse eventsSerum transaminasesBuprenorphine/naloxone treatmentSerious adverse eventsBuprenorphine/naloxoneLong-term outcomesOffice-based treatmentIllicit drug useOpioid useClinical stabilityNaloxone treatmentPrimary outcomePatient satisfactionPrimary careTerm treatmentDrug useUrine samplesPatientsTreatmentTransaminaseOutcomesYearsModerate levelsPercent
2007
Patient Satisfaction with Primary Care Office-Based Buprenorphine/Naloxone Treatment
Barry DT, Moore BA, Pantalon MV, Chawarski MC, Sullivan LE, O’Connor P, Schottenfeld RS, Fiellin DA. Patient Satisfaction with Primary Care Office-Based Buprenorphine/Naloxone Treatment. Journal Of General Internal Medicine 2007, 22: 242-245. PMID: 17356993, PMCID: PMC1824745, DOI: 10.1007/s11606-006-0050-y.Peer-Reviewed Original ResearchConceptsBuprenorphine/naloxonePatient satisfactionBuprenorphine/naloxone treatmentDrug treatment historyOpioid-dependent patientsPrimary care officesOpioid-dependent subjectsSubstance use statusOverall satisfaction scoreOffice visit frequencyNaloxone treatmentParticipantsOne hundredPrimary outcomeCare officesFemale genderTreatment historyPatientsNaloxoneSatisfaction scoresEthnicity/raceTreatment locationUse statusVisit frequencyMedicationsTreatment
2006
Counseling plus Buprenorphine–Naloxone Maintenance Therapy for Opioid Dependence
Fiellin DA, Pantalon MV, Chawarski MC, Moore BA, Sullivan LE, O'Connor PG, Schottenfeld RS. Counseling plus Buprenorphine–Naloxone Maintenance Therapy for Opioid Dependence. New England Journal Of Medicine 2006, 355: 365-374. PMID: 16870915, DOI: 10.1056/nejmoa055255.Peer-Reviewed Original ResearchConceptsStandard medical managementBuprenorphine-naloxone treatmentIllicit opioid useMedical managementOpioid dependenceWeekly medicationOpioid useIllicit opioidsWeekly counselingPrimary careUrine specimensConsecutive weeksProportion of patientsImproved treatment outcomesMaintenance therapyPrimary outcomeClinical trialsMedication distributionSimilar efficacyTreatment outcomesMedicationsSelf-reported frequencyPatientsFrequency of attendanceMean percentageQuality of Care for Acute Myocardial Infarction in Elderly Patients with Alcohol‐Related Diagnoses
Fiellin DA, O'Connor PG, Wang Y, Radford MJ, Krumholz HM. Quality of Care for Acute Myocardial Infarction in Elderly Patients with Alcohol‐Related Diagnoses. Alcohol Clinical And Experimental Research 2006, 30: 70-75. PMID: 16433733, DOI: 10.1111/j.1530-0277.2006.00001.x.Peer-Reviewed Original ResearchConceptsAlcohol-related diagnosesAcute myocardial infarctionMyocardial infarctionElderly patientsEligible patientsCare measuresRetrospective cohort analysisPrincipal discharge diagnosisTime of dischargeCooperative Cardiovascular ProjectAcute care hospitalsMedical record dataQuality of careBaseline characteristicsCare hospitalPrimary outcomeDischarge diagnosisCohort analysisAlcohol abuseMedicare beneficiariesInfarctionPatientsElderly adultsAlcohol dependenceQuality care
2002
Treatment of heroin dependence with buprenorphine in primary care
Fiellin DA, Pantalon MV, Pakes JP, O'Connor PG, Chawarski M, Schottenfeld RS. Treatment of heroin dependence with buprenorphine in primary care. The American Journal Of Drug And Alcohol Abuse 2002, 28: 231-241. PMID: 12014814, DOI: 10.1081/ada-120002972.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, SublingualAdultAmbulatory CareBuprenorphineCombined Modality TherapyConnecticutCounselingDose-Response Relationship, DrugDrug Administration ScheduleFeasibility StudiesFemaleHeroin DependenceHumansMaleMiddle AgedPrimary Health CareSocial SupportTreatment OutcomeUrban PopulationConceptsUrine toxicologyHeroin dependencePrimary careBrief counselingUrine toxicology testsHeroin-dependent patientsPrimary care settingPrimary care centersUrban medical centerBuprenorphine maintenancePrimary outcomeDependent patientsCare centerClinical trialsCare settingsMedical CenterEffective treatmentTreatment retentionBuprenorphinePatientsPotential efficacyToxicology testsMaintenance phaseWeeksCare
1997
A Preliminary Investigation of the Management of Alcohol Dependence With Naltrexone by Primary Care Providers
O’Connor P, Farren C, Rounsaville B, O’Malley S. A Preliminary Investigation of the Management of Alcohol Dependence With Naltrexone by Primary Care Providers. The American Journal Of Medicine 1997, 103: 477-482. PMID: 9428830, DOI: 10.1016/s0002-9343(97)00271-4.Peer-Reviewed Original ResearchConceptsPrimary care providersCare providersGamma-glutamyl transferaseAlcohol dependenceDays abstinentHeavy drinkingSerum gamma-glutamyl transferaseCare treatment modelCompletion of treatmentPercent days abstinentAlcohol-dependent subjectsAlcohol-dependent individualsNaltrexone therapyNumber of drinksPrimary outcomeLiver enzymesPatient ratingsNew patientsGlutamyl transferaseNaltrexoneProvider ratingsBaselineTreatment modelTreatmentDrinking behavior