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 effectivenessHealthBuprenorphine
2023
Computational 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 cohortURINE 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 OUTCOMEIncidence 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 Research
2020
Barriers 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
2015
A randomized clinical trial of emergency department initiated treatment for opioid dependence: Two and six month outcomes
D’Onofrio G, O’Connor P, Pantalon M, Chawarski M, Busch S, Owens P, Bernstein S, Fiellin D. A randomized clinical trial of emergency department initiated treatment for opioid dependence: Two and six month outcomes. Drug And Alcohol Dependence 2015, 156: e53. DOI: 10.1016/j.drugalcdep.2015.07.1062.Peer-Reviewed Original ResearchEmergency Department–Initiated Buprenorphine/Naloxone Treatment for Opioid Dependence: A Randomized Clinical Trial
D’Onofrio G, O’Connor P, Pantalon MV, Chawarski MC, Busch SH, Owens PH, Bernstein SL, Fiellin DA. Emergency Department–Initiated Buprenorphine/Naloxone Treatment for Opioid Dependence: A Randomized Clinical Trial. JAMA 2015, 313: 1636-1644. PMID: 25919527, PMCID: PMC4527523, DOI: 10.1001/jama.2015.3474.Peer-Reviewed Original ResearchConceptsBrief intervention groupOpioid-dependent patientsIllicit opioid useAddiction treatment servicesPercent of patientsBuprenorphine groupEmergency departmentIntervention groupReferral groupOpioid useTreatment servicesBrief interventionOpioid dependenceClinical trialsHIV riskUrban teaching hospital emergency departmentBuprenorphine/naloxone treatmentHuman immunodeficiency virus (HIV) riskTeaching hospital emergency departmentAddiction treatmentBuprenorphine treatment groupUrine samplesBuprenorphine/naloxoneRandomized clinical trialsCommunity-based treatment services
2012
Combining Rapid HIV Testing and a Brief Alcohol Intervention in Young Unhealthy Drinkers in the Emergency Department: A Pilot Study
Edelman EJ, Dinh A, Radulescu R, Lurie B, D'Onofrio G, Tetrault JM, Fiellin DA, Fiellin LE. Combining Rapid HIV Testing and a Brief Alcohol Intervention in Young Unhealthy Drinkers in the Emergency Department: A Pilot Study. The American Journal Of Drug And Alcohol Abuse 2012, 38: 539-543. PMID: 22794939, PMCID: PMC3522092, DOI: 10.3109/00952990.2012.701359.Peer-Reviewed Original ResearchConceptsSexual risk reduction counselingSexual risk behaviorsRisk reduction counselingRapid HIV testingEmergency departmentRisk behaviorsReduction counselingHIV testingAlcohol useUnhealthy drinkersAlcohol consumptionMean age 26 yearsAverage weekly drinksImportant preventive servicesAlcohol Use Disorders Identification Test (AUDIT) scoresUnknown HIV statusRapid HIV testsUnhealthy alcohol useAge 26 yearsBrief alcohol interventionHIV testHIV statusRegular doctorPreventive servicesRisk populations
2005
Development and Implementation of an Emergency Practitioner–Performed Brief Intervention for Hazardous and Harmful Drinkers in the Emergency Department
D'Onofrio G, Pantalon M, Degutis L, Fiellin D, O'Connor P. Development and Implementation of an Emergency Practitioner–Performed Brief Intervention for Hazardous and Harmful Drinkers in the Emergency Department. Academic Emergency Medicine 2005, 12: 249-256. DOI: 10.1111/j.1553-2712.2005.tb00879.x.Peer-Reviewed Original Research