2023
URINE 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 treatmentStimulantsParticipantsBuprenorphineMethadoneBenzodiazepinesSex Difference in Outcomes of Acute Myocardial Infarction in Young Patients
Sawano M, Lu Y, Caraballo C, Mahajan S, Dreyer R, Lichtman J, D'Onofrio G, Spatz E, Khera R, Onuma O, Murugiah K, Spertus J, Krumholz H. Sex Difference in Outcomes of Acute Myocardial Infarction in Young Patients. Journal Of The American College Of Cardiology 2023, 81: 1797-1806. PMID: 37137590, DOI: 10.1016/j.jacc.2023.03.383.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionNoncardiac hospitalizationsSubdistribution HRYounger patientsMyocardial infarctionSex differencesYoung womenCause-specific hospitalizationsCause of hospitalizationWorse health statusSignificant sex disparityNoncardiovascular hospitalizationsVIRGO StudyIndex episodeAdverse outcomesIncidence rateHospitalizationHigh riskSex disparitiesHealth statusPatientsU.S. hospitalsWomenInfarctionOutcomesSex Differences in Symptom Complexity and Door-to-Balloon Time in Patients With ST-Elevation Myocardial Infarction
Brush J, Chaudhry S, Dreyer R, D'Onofrio G, Greene E, Hajduk A, Lu Y, Krumholz H. Sex Differences in Symptom Complexity and Door-to-Balloon Time in Patients With ST-Elevation Myocardial Infarction. The American Journal Of Cardiology 2023, 197: 101-107. PMID: 37062667, PMCID: PMC10198892, DOI: 10.1016/j.amjcard.2023.03.009.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionD2B timeSymptom complexityYoung womenChest painBalloon timeST-elevation myocardial infarctionSILVER-AMI StudySymptom phenotypeSex differencesPain symptomsCoronary interventionOlder patientsMyocardial infarctionOlder womenSTEMIOlder menSymptom patternsPresentation delayPatientsSymptom clustersLogistic regressionSymptomsWomenMean numberRacial 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 analysis
2022
Models for Implementing Emergency Department–Initiated Buprenorphine With Referral for Ongoing Medication Treatment at Emergency Department Discharge in Diverse Academic Centers
Whiteside LK, D'Onofrio G, Fiellin DA, Edelman EJ, Richardson L, O'Connor P, Rothman RE, Cowan E, Lyons MS, Fockele CE, Saheed M, Freiermuth C, Punches BE, Guo C, Martel S, Owens PH, Coupet E, Hawk KF. Models for Implementing Emergency Department–Initiated Buprenorphine With Referral for Ongoing Medication Treatment at Emergency Department Discharge in Diverse Academic Centers. Annals Of Emergency Medicine 2022, 80: 410-419. PMID: 35752520, PMCID: PMC9588652, DOI: 10.1016/j.annemergmed.2022.05.010.Peer-Reviewed Original ResearchConceptsOpioid use disorderUse disordersEmergency Department-Initiated BuprenorphineEmergency department dischargeEmergency department patientsElectronic medical record integrationAcademic medical centerBuprenorphine programDepartment patientsTreatment initiationMedication treatmentEmergency physiciansMedical CenterAmerican CollegeClinical practiceImplementation facilitationQuality improvement processBuprenorphineCommon facilitatorsRecord integrationPatientsReferralED cultureEducational disseminationDisordersUse 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
Improving Emergency Department Throughput Using Audit-and-Feedback With Peer Comparison Among Emergency Department Physicians
Scofi J, Parwani V, Rothenberg C, Patel A, Ravi S, Sevilla M, D'Onofrio G, Ulrich A, Venkatesh AK. Improving Emergency Department Throughput Using Audit-and-Feedback With Peer Comparison Among Emergency Department Physicians. Journal For Healthcare Quality 2021, 44: 69-77. PMID: 34570029, DOI: 10.1097/jhq.0000000000000329.Peer-Reviewed Original ResearchConceptsAdmission ratesEmergency department throughputEmergency physiciansMean timeUrban academic EDEmergency department physiciansMean admission rateLower admission ratesFirst study periodED physiciansAcademic EDDepartment physiciansPatient visitsPractice variationAdmissionPeer comparisonPhysiciansPhysician performanceStudy periodPatientsAcademic emergency physiciansReportAuditMinutesHoursImplementation of Oral and Extended-Release Naltrexone for the Treatment of Emergency Department Patients With Moderate to Severe Alcohol Use Disorder: Feasibility and Initial Outcomes
Anderson ES, Chamberlin M, Zuluaga M, Ullal M, Hawk K, McCormack R, D'Onofrio G, Herring AA. Implementation of Oral and Extended-Release Naltrexone for the Treatment of Emergency Department Patients With Moderate to Severe Alcohol Use Disorder: Feasibility and Initial Outcomes. Annals Of Emergency Medicine 2021, 78: 752-758. PMID: 34353648, DOI: 10.1016/j.annemergmed.2021.05.013.Peer-Reviewed Original ResearchConceptsAlcohol use disorderSevere alcohol use disorderFormal addiction treatmentIntramuscular naltrexoneOral naltrexoneUse disordersAddiction treatmentED patientsExtended-release naltrexoneEffectiveness of naltrexoneEmergency department patientsED dischargeAdult patientsDepartment patientsNaltrexone treatmentEmergency departmentMean ageEffective treatmentNaltrexonePatientsClinical protocolsBrief interventionDescriptive studyDisordersInitial outcomesConsensus Recommendations on the Treatment of Opioid Use Disorder in the Emergency Department
Hawk K, Hoppe J, Ketcham E, LaPietra A, Moulin A, Nelson L, Schwarz E, Shahid S, Stader D, Wilson MP, D'Onofrio G. Consensus Recommendations on the Treatment of Opioid Use Disorder in the Emergency Department. Annals Of Emergency Medicine 2021, 78: 434-442. PMID: 34172303, DOI: 10.1016/j.annemergmed.2021.04.023.Peer-Reviewed Original ResearchConceptsOpioid use disorderEmergency departmentUse disordersConsensus recommendationsEmergency physiciansUntreated opioid use disorderOpioid use disorder treatmentEmergency Physicians (ACEP) recommendationsInitiation of treatmentInitiation of buprenorphineUse disorder treatmentAppropriate patientsED referralsPhysician recommendationTreatment initiationOngoing treatmentAmerican CollegeClinical experienceTreatment linkageExpert consensusDisorder treatmentDrug usePatientsBuprenorphineClinical research
2019
Computerized Clinical Decision Support System for Emergency Department–Initiated Buprenorphine for Opioid Use Disorder: User-Centered Design
Ray JM, Ahmed OM, Solad Y, Maleska M, Martel S, Jeffery MM, Platts-Mills TF, Hess EP, D’Onofrio G, Melnick ER. Computerized Clinical Decision Support System for Emergency Department–Initiated Buprenorphine for Opioid Use Disorder: User-Centered Design. JMIR Human Factors 2019, 6: e13121. PMID: 30810531, PMCID: PMC6414819, DOI: 10.2196/13121.Peer-Reviewed Original ResearchOpioid use disorderRoutine emergency careEmergency departmentCare pathwayED initiationClinical decision supportEmergency careUse disordersEmergency Department-Initiated BuprenorphineRoutine ED careComputerized clinical decision support systemsEffective treatment optionClinical decision toolClinical decision support systemED careTreatment optionsBuprenorphineResident physiciansDirect activationCarePatientsDisordersCritical decision pointsInitial observationsPathway
2018
Emergency department screening and interventions for substance use disorders
Hawk K, D’Onofrio G. Emergency department screening and interventions for substance use disorders. Addiction Science & Clinical Practice 2018, 13: 18. PMID: 30078375, PMCID: PMC6077851, DOI: 10.1186/s13722-018-0117-1.Peer-Reviewed Original Research
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 accessPatientsCost‐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 daysInterventionEmergency Department-Initiated Buprenorphine for Opioid Dependence with Continuation in Primary Care: Outcomes During and After Intervention
D’Onofrio G, Chawarski MC, O’Connor P, Pantalon MV, Busch SH, Owens PH, Hawk K, Bernstein SL, Fiellin DA. Emergency Department-Initiated Buprenorphine for Opioid Dependence with Continuation in Primary Care: Outcomes During and After Intervention. Journal Of General Internal Medicine 2017, 32: 660-666. PMID: 28194688, PMCID: PMC5442013, DOI: 10.1007/s11606-017-3993-2.Peer-Reviewed Original ResearchConceptsIllicit opioid useOpioid usePrimary careHIV riskBrief interventionAddiction treatmentBuprenorphine groupEmergency Department-Initiated BuprenorphineCohort of patientsLong-term followLong-term outcomesFormal addiction treatmentSignificant differencesMain MeasuresSelfStudy entryUrine toxicologyBuprenorphine/Opioid dependenceED interventionsUrine resultsBuprenorphineTreatment engagementDrug useReferralPatientsMultiple Fentanyl Overdoses — New Haven, Connecticut, June 23, 2016
Tomassoni AJ, Hawk KF, Jubanyik K, Nogee DP, Durant T, Lynch KL, Patel R, Dinh D, Ulrich A, D’Onofrio G. Multiple Fentanyl Overdoses — New Haven, Connecticut, June 23, 2016. MMWR Morbidity And Mortality Weekly Report 2017, 66: 107-111. PMID: 28151928, PMCID: PMC5657834, DOI: 10.15585/mm6604a4.Peer-Reviewed Case Reports and Technical NotesConceptsIntensive care unitEmergency departmentYale-New Haven HospitalEmergency medical services (EMS) crewsInterviews of patientsContinuous naloxone infusionNew Haven HospitalPublic health alertsRespiratory failureCare unitNaloxone infusionEndotracheal intubationOpioid overdoseNaloxone distributionPatientsRoute of intoxicationSubsequent episodesHealth alertsOpioid antidoteFentanylHospitalPublic healthFamily membersCocaineRapid notificationPerceived Stress After Acute Myocardial Infarction
Xu X, Bao H, Strait KM, Edmondson DE, Davidson KW, Beltrame JF, Bueno H, Lin H, Dreyer RP, Brush JE, Spertus JA, Lichtman JH, D'Onofrio G, Krumholz HM. Perceived Stress After Acute Myocardial Infarction. Psychosomatic Medicine 2017, 79: 50-58. PMID: 27984507, PMCID: PMC5459399, DOI: 10.1097/psy.0000000000000429.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPSS-14 scoreMiddle-aged patientsPatient characteristicsMyocardial infarctionSex differencesMonths of recoveryAMI anginaInitial hospitalizationPerceived Stress ScalePatientsAnginaLess improvementLinear mixed-effects modelsFirst monthPsychological stressMixed-effects modelsWomenMonthsHigh levelsMenInfarctionStress ScalePerceived stress
2016
MICROVASCULAR ANGINA IN THE ABSENCE OF CORONARY ARTERY DISEASE IS COMMON IN UNDIFFERENTIATED CHEST PAIN PATIENTS IN THE EMERGENCY DEPARTMENT
Safdar B, D’Onofrio G, Dziura J, Russell R, Naftilan M, Johnson C, Sinusas A. MICROVASCULAR ANGINA IN THE ABSENCE OF CORONARY ARTERY DISEASE IS COMMON IN UNDIFFERENTIATED CHEST PAIN PATIENTS IN THE EMERGENCY DEPARTMENT. Journal Of The American College Of Cardiology 2016, 67: 1824. DOI: 10.1016/s0735-1097(16)31825-3.Peer-Reviewed Original Research
2015
SEX DIFFERENCES IN 12-MONTH HEALTH STATUS IN YOUNG PATIENTS FOLLOWING ACUTE MYOCARDIAL INFARCTION: RESULTS FROM THE VIRGO STUDY (VARIATION IN RECOVERY: ROLE OF GENDER ON OUTCOMES OF YOUNG ACUTE MYOCARDIAL INFARCTION PATIENTS)
Dreyer R, Wang Y, Strait K, Lorenze N, D’Onofrio G, Bueno H, Lichtman J, Spertus J, Krumholz H. SEX DIFFERENCES IN 12-MONTH HEALTH STATUS IN YOUNG PATIENTS FOLLOWING ACUTE MYOCARDIAL INFARCTION: RESULTS FROM THE VIRGO STUDY (VARIATION IN RECOVERY: ROLE OF GENDER ON OUTCOMES OF YOUNG ACUTE MYOCARDIAL INFARCTION PATIENTS). Journal Of The American College Of Cardiology 2015, 65: a6. DOI: 10.1016/s0735-1097(15)60006-7.Peer-Reviewed Original Research
2013
A Promising Approach For Emergency Departments To Care For Patients With Substance Use And Behavioral Disorders
Bernstein SL, D’Onofrio G. A Promising Approach For Emergency Departments To Care For Patients With Substance Use And Behavioral Disorders. Health Affairs 2013, 32: 2122-2128. PMID: 24301395, DOI: 10.1377/hlthaff.2013.0664.Peer-Reviewed Original ResearchConceptsEmergency departmentPrimary care systemSubstance useBehavioral disordersCare systemAcuity of illnessUS emergency departmentsHigh patient volumeNation's primary care systemMillions of patientsHealth care systemED patientsBody of evidenceBrief interventionPatientsPatient volumeSBIRTMotivational interviewingHealth of millionsDisordersRisky behaviorsCounseling techniquesReflective listeningDepartmentAcuity
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