2023
Perspectives 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 implementationPerspectives 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 OUTCOME
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 1Perspectives 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
A 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
Use of Amphetamine-Type Stimulants Among Emergency Department Patients With Untreated Opioid Use Disorder
Chawarski MC, Hawk K, Edelman EJ, O'Connor P, Owens P, Martel S, Coupet E, Whiteside L, Tsui JI, Rothman R, Cowan E, Richardson L, Lyons MS, Fiellin DA, D'Onofrio G. Use of Amphetamine-Type Stimulants Among Emergency Department Patients With Untreated Opioid Use Disorder. Annals Of Emergency Medicine 2020, 76: 782-787. PMID: 32782084, PMCID: PMC8048036, DOI: 10.1016/j.annemergmed.2020.06.046.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderAmphetamine-type stimulant useUse disordersStimulant useAmphetamine-type stimulantsStudy admissionEmergency departmentEmergency department patientsImplementation science studyUrine test resultsFalse discovery rate correctionSubstance use problemsHepatitis CED visitsDepartment patientsReferral protocolsED patientsUrine testsDrug injectionOverdose riskPatientsHealth factorsUnstable housingConcurrent useBarriers 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
2019
Implementation facilitation to promote emergency department-initiated buprenorphine for opioid use disorder: protocol for a hybrid type III effectiveness-implementation study (Project ED HEALTH)
D’Onofrio G, Edelman EJ, Hawk KF, Pantalon MV, Chawarski MC, Owens PH, Martel SH, VanVeldhuisen P, Oden N, Murphy SM, Huntley K, O’Connor P, Fiellin DA. Implementation facilitation to promote emergency department-initiated buprenorphine for opioid use disorder: protocol for a hybrid type III effectiveness-implementation study (Project ED HEALTH). Implementation Science 2019, 14: 48. PMID: 31064390, PMCID: PMC6505286, DOI: 10.1186/s13012-019-0891-5.Peer-Reviewed Original ResearchConceptsOpioid use disorderEmergency departmentImplementation facilitationCost-effectiveness analysisUse disordersPatient engagementEmergency department-initiated buprenorphineEffectiveness-implementation studyEvaluation periodOpioid agonist treatmentSoft tissue infectionsInjection drug useGeneral medical conditionsHealth Services frameworkClinical Trials NetworkAcademic emergency departmentRate of provisionIF interventionOngoing medicationED visitsTissue infectionsED patientsFacilitated referralAgonist treatmentED providers
2017
Cost‐effectiveness of emergency department‐initiated treatment for opioid dependence
Busch SH, Fiellin DA, Chawarski MC, Owens PH, Pantalon MV, Hawk K, Bernstein SL, O'Connor PG, D'Onofrio G. Cost‐effectiveness of emergency department‐initiated treatment for opioid dependence. Addiction 2017, 112: 2002-2010. PMID: 28815789, PMCID: PMC5657503, DOI: 10.1111/add.13900.Peer-Reviewed Original ResearchConceptsCost-effectiveness acceptability curvesOpioid dependenceCommunity-based treatmentBrief interventionAcceptability curvesPast weekHealth care system costsHealth care system perspectiveAddiction treatmentOpioid-dependent patientsPatient time costsHealth care useFormal addiction treatmentBuprenorphine treatmentUrban EDEmergency departmentPrimary carePatient engagementTreatment engagementPatientsReferralSecondary analysisBuprenorphineNumber of daysIntervention
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
Development of a scale to measure practitioner adherence to a brief intervention in the emergency department
Pantalon MV, Martino S, Dziura J, Li FY, Owens PH, Fiellin DA, O'Connor PG, D'Onofrio G. Development of a scale to measure practitioner adherence to a brief intervention in the emergency department. Journal Of Substance Use And Addiction Treatment 2012, 43: 382-388. PMID: 23021098, PMCID: PMC3661016, DOI: 10.1016/j.jsat.2012.08.011.Peer-Reviewed Original ResearchConceptsBrief Negotiation InterviewBrief interventionTwo-factor structureExcellent internal consistencyGood construct validityDiscriminant validityPredictive validityEmergency departmentExcellent inter-rater reliabilityPsychometric propertiesEight-itemConstruct validityHazardous drinkingInternal consistencyEmergency department patientsPractitioner adherenceInter-rater reliabilityDepartment patientsAdherence ScaleClinical practiceValidityInterventionSkillsAdherenceScale
2008
Brief Intervention for Hazardous and Harmful Drinkers in the Emergency Department
D'Onofrio G, Pantalon MV, Degutis LC, Fiellin DA, Busch SH, Chawarski MC, Owens PH, O'Connor PG. Brief Intervention for Hazardous and Harmful Drinkers in the Emergency Department. Annals Of Emergency Medicine 2008, 51: 742-750.e2. PMID: 18436340, PMCID: PMC2819119, DOI: 10.1016/j.annemergmed.2007.11.028.Peer-Reviewed Original ResearchConceptsBrief Negotiation InterviewBinge-drinking episodesHarmful drinkersBrief interventionDischarge instructionsPatients 18 yearsRandomized clinical trialsEmergency department settingMean numberInterview groupAlcoholism guidelinesBaseline characteristicsUrban EDAlcohol ingestionED patientsEmergency departmentClinical trialsDepartment settingAlcohol abuseAlcohol consumptionEmergency practitionersTreatment servicesHarmful drinkingMonthsDrinkers
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 ResearchDevelopment and Implementation of an Emergency Practitioner–Performed Brief Intervention for Hazardous and Harmful Drinkers in the Emergency Department
D'Onofrio G, Pantalon MV, Degutis LC, Fiellin DA, O'Connor PG. 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. PMID: 15741590, PMCID: PMC1414059, DOI: 10.1197/j.aem.2004.10.021.Peer-Reviewed Original ResearchConceptsBrief Negotiation InterviewEmergency practitionersEmergency departmentBrief interventionClinical careEfficacy of BIRoutine clinical careMean durationPatient outcomesHarmful drinkersStandardized patient scenariosClinical practicePatient scenariosDrinkersMean numberInterventionTraining sessionsCarePilot testingDepartmentSessionsHospitalTrials