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 OUTCOMERacial 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 analysisReal-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 policiesInterventionOutcomesPrescriptionAssociation 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 ratioConcordance between controlled substance receipt and post-mortem toxicology in opioid-detected overdose deaths: A statewide analysis
Howell B, Black A, Grau L, Lin H, Greene C, Lee H, Heimer R, Hawk K, D'Onofrio G, Fiellin D, Becker W. Concordance between controlled substance receipt and post-mortem toxicology in opioid-detected overdose deaths: A statewide analysis. Drug And Alcohol Dependence 2023, 244: 109788. PMID: 36738634, PMCID: PMC9975083, DOI: 10.1016/j.drugalcdep.2023.109788.Peer-Reviewed Original ResearchConceptsPost-mortem toxicologyOverdose deathsChief Medical ExaminerBenzodiazepine prescribingBenzodiazepine prescriptionsPrimary outcomePreventable deathsOpioid overdosesOpioidsAddiction servicesBenzodiazepinesMental healthStudy periodDeathMedical examinersConcordanceStatewide analysisSubstantial numberReceiptDaysDepartmentMedicationsToxicologyFentanylPrescribing
2022
Use 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 reductionOutcomes
2021
Development and Validation of a Risk Prediction Model for 1‐Year Readmission Among Young Adults Hospitalized for Acute Myocardial Infarction
Dreyer RP, Raparelli V, Tsang SW, D’Onofrio G, Lorenze N, Xie CF, Geda M, Pilote L, Murphy TE. Development and Validation of a Risk Prediction Model for 1‐Year Readmission Among Young Adults Hospitalized for Acute Myocardial Infarction. Journal Of The American Heart Association 2021, 10: e021047. PMID: 34514837, PMCID: PMC8649501, DOI: 10.1161/jaha.121.021047.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPrior acute myocardial infarctionRisk prediction modelMyocardial infarctionYoung adultsDepressive symptomsLonger inpatient lengthPredictors of readmissionFinal risk modelYear of dischargeBetter physical healthAMI severityBackground ReadmissionHospital complicationsVIRGO StudyCause readmissionHospital lengthHospital dischargeYounger patientsDevelopment of interventionsDiabetes mellitusHeart failurePrimary outcomeConclusions WomenMean ageThe 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
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 boardBuprenorphine
2017
Patient Ethnicity Predicts Poor Health Access and Gaps in Perception of Personal Cardiovascular Risk Factors
Kim Y, Hogan K, D’Onofrio G, Chekijian S, Safdar B. Patient Ethnicity Predicts Poor Health Access and Gaps in Perception of Personal Cardiovascular Risk Factors. Critical Pathways In Cardiology A Journal Of Evidence-Based Medicine 2017, 16: 147-157. PMID: 29135623, DOI: 10.1097/hpc.0000000000000132.Peer-Reviewed Original ResearchConceptsCoronary artery disease risk factorsDisease risk factorsOwn cardiovascular riskCardiovascular risk factorsRisk factorsConsecutive patientsPersonal cardiovascular risk factorsHealth literacy campaignsPoor health accessCoronary risk factorsTertiary care hospitalPrimary care physiciansPersonal risk factorsIndividual risk factorsCross-sectional surveyChest painCardiovascular riskSecondary outcomesCare hospitalPrimary outcomeCare physiciansPatient misperceptionsPatient ethnicityHealth accessPatientsRanolazine and Microvascular Angina by PET in the Emergency Department: Results From a Pilot Randomized Controlled Trial
Safdar B, D’Onofrio G, Dziura J, Russell RR, Johnson C, Sinusas AJ. Ranolazine and Microvascular Angina by PET in the Emergency Department: Results From a Pilot Randomized Controlled Trial. Clinical Therapeutics 2017, 39: 55-63. PMID: 28081848, PMCID: PMC10345862, DOI: 10.1016/j.clinthera.2016.12.002.Peer-Reviewed Original ResearchConceptsCoronary microvascular dysfunctionCoronary flow reserveCoronary artery diseaseChest painSymptomatic patientsArtery diseasePrimary outcomeEmergency departmentNonobstructive coronary artery diseaseRb-82 positron emission tomographyEffect of ranolazineRate-pressure productEmergency department patientsQTc-prolonging drugsRobust clinical trialsPositron emission tomographyHypertensive urgencyMicrovascular anginaMicrovascular dysfunctionUnderdiagnosed causeControlled TrialsDepartment patientsHeart failureAcute symptomsPressure product
2015
Successful Tobacco Dependence Treatment in Low-Income Emergency Department Patients: A Randomized Trial
Bernstein SL, D’Onofrio G, Rosner J, O’Malley S, Makuch R, Busch S, Pantalon MV, Toll B. Successful Tobacco Dependence Treatment in Low-Income Emergency Department Patients: A Randomized Trial. Annals Of Emergency Medicine 2015, 66: 140-147. PMID: 25920384, PMCID: PMC4819432, DOI: 10.1016/j.annemergmed.2015.03.030.Peer-Reviewed Original ResearchConceptsEmergency department patientsDepartment patientsUS EDsTobacco abstinence ratesGroup of smokersTobacco dependence treatmentMultivariable logistic modelingState Smokers' QuitlineLow incomeED smokersFaxed referralsQuitline referralQuitline useSecondary endpointsEligible subjectsPrimary outcomeIntervention armMedicaid insuranceNicotine patchNicotine replacementAbstinence ratesBooster callsIntervention subjectsControl armControl subjects
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
2010
Simulation Training in Central Venous Catheter Insertion: Improved Performance in Clinical Practice
Evans LV, Dodge KL, Shah TD, Kaplan LJ, Siegel MD, Moore CL, Hamann CJ, Lin Z, D'Onofrio G. Simulation Training in Central Venous Catheter Insertion: Improved Performance in Clinical Practice. Academic Medicine 2010, 85: 1462-1469. PMID: 20736674, DOI: 10.1097/acm.0b013e3181eac9a3.Peer-Reviewed Original ResearchMeSH KeywordsCatheterization, Central VenousChi-Square DistributionClinical CompetenceCompetency-Based EducationEducation, Medical, GraduateEducational MeasurementHumansIntensive Care UnitsInternship and ResidencyPatient SimulationProspective StudiesRegression AnalysisSingle-Blind MethodStatistics, NonparametricUltrasonography, InterventionalConceptsCentral venous catheter insertionVenous catheter insertionCVC insertionFirst cannulationIntervention groupControl groupCatheter insertionMechanical complicationsClinical practiceTertiary care teaching hospitalSingle-blind studyInsertion success rateTechnical errorsBlinded independent ratersSimulation trainingPatient comorbiditiesPrimary outcomeSecondary outcomesTeaching hospitalInsertion successSecond-year residentsCannulationResident specialtyConfidence intervalsSimulation training course
2006
Intravenous Morphine Plus Ketorolac Is Superior to Either Drug Alone for Treatment of Acute Renal Colic
Safdar B, Degutis LC, Landry K, Vedere SR, Moscovitz HC, D’Onofrio G. Intravenous Morphine Plus Ketorolac Is Superior to Either Drug Alone for Treatment of Acute Renal Colic. Annals Of Emergency Medicine 2006, 48: 173-181.e1. PMID: 16953530, DOI: 10.1016/j.annemergmed.2006.03.013.Peer-Reviewed Original ResearchConceptsAcute renal colicRenal colicRescue analgesiaMorphine groupCombination of morphineHours of presentationVerbal pain scalePresence of peritonitisVisual analog scaleAnti-inflammatory drugsIntravenous ketorolacKetorolac groupRescue morphineIntravenous morphinePain reductionPain reliefPain scoresModerate painPain scaleConsecutive patientsPrimary outcomeAnalog scaleCombination therapyEmergency departmentPain ratings